Provider Demographics
NPI:1134292154
Name:REDDY, NAVEEN GUNDA (MD)
Entity Type:Individual
Prefix:DR
First Name:NAVEEN
Middle Name:GUNDA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5701 BOW POINTE DR
Mailing Address - Street 2:SUITE 370
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-3198
Mailing Address - Country:US
Mailing Address - Phone:248-625-4055
Mailing Address - Fax:248-625-4085
Practice Address - Street 1:5701 BOW POINTE DR
Practice Address - Street 2:SUITE 370
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-3198
Practice Address - Country:US
Practice Address - Phone:248-625-4055
Practice Address - Fax:248-625-4085
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2020-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI4301095371207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP32350007Medicare PIN