Sahithi Gogineni

Individual provider Active NPI Psychiatry Physician · Detroit, MI

NPI 1972166304 · NPPES record last updated May 20, 2025

Key facts

NPI
1972166304
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
4301509955 (MI)
Practice address
4646 John R St
Detroit, MI 48201-1916
Phone
(313) 576-1000
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4301509955MIMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 4301509955 MI Yes

Addresses

Primary practice location

4646 John R St
Detroit, MI 48201-1916

Mailing address

3990 John R St
Detroit, MI 48201-2018

Other providers in Detroit, MI

All providers in Detroit, MI · Psychiatry Physician in Michigan

Sources for this page

Verify at the official NPI Registry.