Digestive Diseases & Clinical Nutrition Center, PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

SM010585 Issued in MI

Legal business name

DIGESTIVE DISEASES & CLINICAL NUTRITION CENTER, PC

Practice address

1345 Willowdale CT Ste a
Flint, MI 48532-4736

Phone

(810) 720-5130

Fax

(810) 720-4661

NPI assigned

Jul 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sreen Mannam, M.D.

Title

Gastroenterologist

Phone

(810) 720-5130

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sreenivas Mannam, M.D.

  • Gastroenterology Physician
  • Flint, MI
  • NPI 1629001334
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447271515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 WILLOWDALE CT STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324736",
            "telephone_number": "810-720-5130",
            "fax_number": "810-720-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 WILLOWDALE CT STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324736",
            "telephone_number": "810-720-5130",
            "fax_number": "810-720-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASES & CLINICAL NUTRITION CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANNAM",
        "authorized_official_first_name": "SREEN",
        "authorized_official_title_or_position": "GASTROENTEROLOGIST",
        "authorized_official_telephone_number": "810-720-5130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "SM010585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Diehm, OTR/L
• Julianne Diem
• Diana J. Diesch
• Melonie Dieugenio
• Paul J. Diffenderffer, CRNA
• Digestive Health Clinic
• Starletta Faye Diggs
• Dilip M Desai
• Samuel L Dillard
• Shakira Dillard

• Gastroenterology Physician in Flint, MI
• Providers in Flint, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.