Provider Demographics
NPI:1922299825
Name:REDDY, REENA (MD)
Entity Type:Individual
Prefix:
First Name:REENA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REENA
Other - Middle Name:
Other - Last Name:AHLUWALIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6231 N CANTON CENTER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2693
Mailing Address - Country:US
Mailing Address - Phone:734-455-0800
Mailing Address - Fax:734-455-0818
Practice Address - Street 1:6231 N CANTON CENTER RD STE 101
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2693
Practice Address - Country:US
Practice Address - Phone:734-455-0800
Practice Address - Fax:734-455-0818
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128026208000000X
IA123ABC208M00000X
MI4301084105208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist