Provider Demographics
NPI:1972568087
Name:DONTHIREDDY, VIJAYALAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:VIJAYALAKSHMI
Middle Name:
Last Name:DONTHIREDDY
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 1:3922 KNIGHTBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-4533
Mailing Address - Country:US
Mailing Address - Phone:586-254-3763
Mailing Address - Fax:
Practice Address - Street 1:MACOMB HEMATOLOGY ONCOLOGY
Practice Address - Street 2:11900 EAST 12MILE SUITE 210
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093
Practice Address - Country:US
Practice Address - Phone:586-558-4700
Practice Address - Fax:586-558-4706
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315011249207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology