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General NPI Number Information
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NPI Number | 1740576800
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Entity Type | Individual
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Provider Name | DEEPTI G. REDDY M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 210 LITTLE LAKE DR STE 10
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City | ANN ARBOR
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State | MI
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Zip | 48103-6218
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Country | US
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Telephone | 734-332-9936
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Fax | 206-666-2989
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Provider Business Mailing Address
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Address Line | 210 LITTLE LAKE DR STE 10
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City | ANN ARBOR
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State | MI
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Zip | 48103-6218
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Country | US
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Telephone | 734-332-9936
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Fax | 206-666-2989
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 4301098843
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License Number State | MI
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