Provider Demographics
NPI:1841398880
Name:GOTTAM, NARSIMHA REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:NARSIMHA
Middle Name:REDDY
Last Name:GOTTAM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:7633 E JEFFERSON AVE
Mailing Address - Street 2:SUITE #360
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3732
Mailing Address - Country:US
Mailing Address - Phone:313-499-4769
Mailing Address - Fax:313-822-2791
Practice Address - Street 1:7633 E JEFFERSON AVE.
Practice Address - Street 2:SUITE #360
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3732
Practice Address - Country:US
Practice Address - Phone:313-499-4769
Practice Address - Fax:313-822-2791
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2012-11-01
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Provider Licenses
StateLicense IDTaxonomies
MI4301045265207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease