Provider Demographics
NPI:1245206598
Name:REDDY, GUNDA SATHYANARAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:GUNDA
Middle Name:SATHYANARAYA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2832 CROFTSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4925
Mailing Address - Country:US
Mailing Address - Phone:248-608-6298
Mailing Address - Fax:810-245-6993
Practice Address - Street 1:3273 DAVISON RD
Practice Address - Street 2:STE 1
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2902
Practice Address - Country:US
Practice Address - Phone:810-245-3188
Practice Address - Fax:810-245-6993
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301043925207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4069165Medicaid
MI0D41013OtherBLUECROSS
MI0N16580Medicare ID - Type Unspecified
MIB47560Medicare UPIN