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LINGAREDDY DEVIREDDY MD PC NPI 1194115402


NPI Information

NPI: 1194115402
Provider Name: LINGAREDDY DEVIREDDY MD PC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
11900 E 12 MILE RD
SUITE 103
WARREN, MI
ZIP 48093
Phone: (586) 574-0890
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LINGAREDDY DEVIREDDY MD PC is a medical specialty clinic center in Warren, MI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). LINGAREDDY DEVIREDDY MD PC NPI is 1194115402. The provider is registered as an organization entity type.

The provider's business location address is:

11900 E 12 MILE RD
SUITE 103
WARREN, MI
ZIP 48093-400
Phone: (586) 574-0890
Fax: (586) 574-9321

The provider's authorized official is Srinivas Koneru .
The authorized official title is Md and has the following contact phone number (586) 574-0890.

The enumeration date for this NPI number is 1/26/2015 and was last updated on 1/26/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical Specialty4301080674MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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