Provider Demographics
NPI:1851787782
Name:REDDY, SUNIL SANDADI (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:SANDADI
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S MIAMI AVE UNIT 4109
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4494
Mailing Address - Country:US
Mailing Address - Phone:740-972-9277
Mailing Address - Fax:
Practice Address - Street 1:4210 SAINT ANTOINE ST
Practice Address - Street 2:UNIVERSITY HEALTH CENTER 7C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2108
Practice Address - Country:US
Practice Address - Phone:313-577-5222
Practice Address - Fax:313-577-5217
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT4832208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program