Endocrinology and Diabetes Center of Port Huron PLLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

ENDOCRINOLOGY AND DIABETES CENTER OF PORT HURON PLLC

Practice address

4190 24TH Ave
Suite: 201
Fort Gratiot, MI 48059-3882

Phone

(810) 989-7478

Fax

(810) 989-7644

NPI assigned

Nov 16, 2005

Organization subpart

No

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

Authorized official

Name

Sushma Reddy, MDNPI 1427044981

Title

General Partner

Phone

(810) 989-7478

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sushma Reddy, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Gratiot, MI
  • NPI 1427044981
  NPD (past) Authorized official

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1669454559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE",
            "address_2": "SUITE: 201",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593882",
            "telephone_number": "810-989-7478",
            "fax_number": "810-989-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE",
            "address_2": "SUITE: 201",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593882",
            "telephone_number": "810-989-7478",
            "fax_number": "810-989-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY AND DIABETES CENTER OF PORT HURON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SUSHMA",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "810-989-7478",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Ebmeyer
• Alexis Jade Edie
• Haley Paige Eisenhauer
• Radwa Elrefai
• George Salter Emerson III
• Emily Erdmann
• Christina Evanko, BCBA, LBA
• Sarah L Evans
• Amy Fabick, MSW
• Fahim K Ibrahim M.D., P.C.

• Endocrinology, Diabetes & Metabolism Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.