Provider Demographics
NPI:1609989193
Name:MOVVA, USHA RANI (MD)
Entity type:Individual
Prefix:DR
First Name:USHA
Middle Name:RANI
Last Name:MOVVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:USHA
Other - Middle Name:RANI
Other - Last Name:POTLURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 CHAMBERS ROAD
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-9296
Mailing Address - Country:US
Mailing Address - Phone:989-673-3191
Mailing Address - Fax:989-673-0064
Practice Address - Street 1:2000 CHAMBERS ROAD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9296
Practice Address - Country:US
Practice Address - Phone:989-673-3191
Practice Address - Fax:989-673-0064
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4075842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI260031958OtherRAILROAD MEDICARE TBHS
MI104866891Medicaid
MI30744OtherBCBS FOR THE LIGHTHOUSE
MI700B660020OtherBCBS FOR TBHS
MI260046941OtherRAILROAD - HEALTHSOURCE
MI2607976902OtherBLUE CROSS BLUE SHIELD
MI260036991OtherRAILROAD MEDICARE
MI4277829Medicaid
MI700G360520OtherBCBS HEALTHSOURCE SAGINAW
MIOG91007OtherBCBS FOR LIST
MI103027170Medicaid
MIF00428Medicare UPIN
0G96036006Medicare PIN
MI700B660020OtherBCBS FOR TBHS
MI260046941OtherRAILROAD - HEALTHSOURCE
MI0B66002004Medicare PIN
MI104866891Medicaid