MEDICARE: DR. CHANDRA S REDDY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	CR031554	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MI4989	OTHER	MI	GROUP PTAN
3	1295023547	OTHER	MI	GROUP NPI (MICHIGAN HEALTHCARE PROFESSIONALS PC)

General Provider Information

NPI Number	:	1083649545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHANDRA S REDDY M.D.

Provider Business Mailing Address
First Line	:	1854 W AUBURN RD STE 100B
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3868
Country	:	US
Telephone Number	:	248-656-5800
Fax Number	:	248-656-5802

Provider Business Practice Location Address
First Line	:	1854 W AUBURN RD STE 100B
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3868
Country	:	US
Telephone Number	:	248-656-5800
Fax Number	:	248-656-5802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/17/2018

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Directions to “ DR. CHANDRA S REDDY M.D.” Practice Location

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