Provider Demographics
NPI:1609615699
Name:VELUGOTI, LAKSHMI SAI DEEPAK REDDY
Entity type:Individual
Prefix:
First Name:LAKSHMI SAI DEEPAK
Middle Name:REDDY
Last Name:VELUGOTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6245 INKSTER RD GARDEN CITY HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135
Mailing Address - Country:US
Mailing Address - Phone:734-458-3614
Mailing Address - Fax:
Practice Address - Street 1:6245 INKSTER RD GARDEN CITY HOSPITAL
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135
Practice Address - Country:US
Practice Address - Phone:734-458-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program