Provider Demographics
NPI:1316642671
Name:ANUGU, NAGASPURTHY REDDY (MD)
Entity type:Individual
Prefix:
First Name:NAGASPURTHY REDDY
Middle Name:
Last Name:ANUGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22201 MOROSS RD
Mailing Address - Street 2:SUITE 80
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-3800
Mailing Address - Fax:313-343-4756
Practice Address - Street 1:22201 MOROSS RD
Practice Address - Street 2:SUITE 80
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-3800
Practice Address - Fax:313-343-4756
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5315239809208000000X
MI4351050719208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics