Chakradhar C Reddy MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

034413 Issued in MI

Legal business name

CHAKRADHAR C REDDY MD PC

Practice address

36232 Garfield Rd
Clinton TWP, MI 48035-1128

Phone

(586) 791-5210

Fax

(586) 791-0049

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Premlatha C Reddy

Title

Manager

Phone

(586) 791-5210

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1508909128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36232 GARFIELD RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480351128",
            "telephone_number": "586-791-5210",
            "fax_number": "586-791-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36232 GARFIELD RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480351128",
            "telephone_number": "586-791-5210",
            "fax_number": "586-791-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAKRADHAR C REDDY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PREMLATHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-791-5210",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "034413",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508909128",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301034413",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.