Provider Demographics
NPI:1063868636
Name:REDDY & KUNADI MD PLC
Entity type:Organization
Organization Name:REDDY & KUNADI MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-694-8423
Mailing Address - Street 1:414 PERRY RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1467
Mailing Address - Country:US
Mailing Address - Phone:810-694-8423
Mailing Address - Fax:810-694-9280
Practice Address - Street 1:414 PERRY RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1467
Practice Address - Country:US
Practice Address - Phone:810-694-8423
Practice Address - Fax:810-694-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicare PIN