NPIMap

Organization Active NPI

Pavan G Reddy MD PLLC

  • Otolaryngology Physician
  • Southgate, MI
National Provider Identifier
1619143807
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301063732 Issued in MI
Legal business name
PAVAN G REDDY MD PLLC
Practice address
14500 Northline Rd
Southgate, MI 48195-2402
Phone
(734) 281-4197
Fax
(734) 282-0093
NPI assigned
May 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Dr. Pavan G Reddy, MD
Title
Owner
Phone
(734) 281-4197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 4301063732 MI Primary

Addresses

Primary practice location

14500 Northline Rd
Southgate, MI 48195-2402

Mailing address

14500 Northline Rd
Southgate, MI 48195-2402
Phone (734) 281-4197

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1619143807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14500 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952402",
            "telephone_number": "734-281-4197",
            "fax_number": "734-282-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952402",
            "telephone_number": "734-281-4197",
            "fax_number": "734-282-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVAN G REDDY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PAVAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-281-4197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301063732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.