Provider Demographics
NPI:1538055355
Name:KESIREDDY, SRIJA REDDY (MD)
Entity type:Individual
Prefix:
First Name:SRIJA REDDY
Middle Name:
Last Name:KESIREDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 430150
Mailing Address - Street 2:HONOR COMMUNITY HEALTH
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48343-0150
Mailing Address - Country:US
Mailing Address - Phone:248-724-7600
Mailing Address - Fax:248-857-7141
Practice Address - Street 1:461 WEST HURON STREET SUITE 107
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-724-7600
Practice Address - Fax:248-857-7141
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program