DR. LAKSHMI SUBBA NELLUTLA


Address: 7733 E Jefferson Ave, Detroit, MI 48214-3707
Phone: 3134994900

DR. LAKSHMI SUBBA NELLUTLA (NPI# 1629216007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629216007
Entity Type Individual
Full Name DR. LAKSHMI SUBBA NELLUTLA
Credential MD
Practice Address 7733 E Jefferson Ave
Detroit
MI 48214-3707
Mailing Address 17197 N Laurel Park Dr
Suite 161
Livonia
MI 48152-2680
Practice Telephone 3134994900
Practice Fax Number 3134994483
Mailing Telephone 7343388300
Mailing Fax Number 7343388301
Enumeration Date 2009-01-23
Last Update Date 2010-10-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 4301093294 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI BCBS GROUP NUMBER 700H231390 01

Office Location

Street Address 7733 E JEFFERSON AVE
City DETROIT
State MI
Zip Code 48214-3707

Providers in the same location

NPI Name Taxonomy Address Enumeration
1881681955 Patricia Barszenski Nurse Practitioner 7733 E Jefferson Ave, 1350, Detroit, MI 48214-3707 2005-10-04
1790030690 Ccla9, LLC Skilled Nursing Facility 7733 E Jefferson Ave, Detroit, MI 48214-3707 2012-07-17
1295018745 Ccla 9 LLC Skilled Nursing Facility 7733 E Jefferson Ave, Detroit, MI 48214-3707 2011-09-21
1922257401 Medical Resource Group Clinic/Center 7733 E Jefferson Ave, Detroit, MI 48214-3707 2008-09-09
1013174655 St John Macomb Oakland Hospital Pathology 7733 E Jefferson Ave, Detroit, MI 48214-3707 2008-05-21
1033376538 St John Macomb Oakland Hospital Family Medicine 7733 E Jefferson Ave, Detroit, MI 48214-3707 2008-05-21
1326205964 St John Macomb Oakland Hospital Emergency Medicine 7733 E Jefferson Ave, Detroit, MI 48214-3707 2008-05-21
1770750309 St John Macomb Oakland Hospital General Acute Care Hospital 7733 E Jefferson Ave, Detroit, MI 48214-3707 2008-05-13
1245406875 Dr. Kerry L. Kole PC Surgery 7733 E Jefferson Ave, Detroit, MI 48214-3707 2008-05-04
1871783530 Medical Resource Group Emergency Medicine 7733 E Jefferson Ave, Detroit, MI 48214-3707 2007-07-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1376042325 Tamara Wesley Registered Nurse 9000 E. Jefferson Apt 28-14, Detroit, MI 48214 2018-02-06
1720534381 Birth Beautiful Detroit Clinic/Center 1086 Baldwin, Detroit, MI 48214 2016-09-01
1225402886 Steven Doyle Whatley I Counselor 1423 Field Ave., Adult Well Being Services, Detroit, MI 48214 2015-11-19
1255587945 Andrew Avery Internal Medicine 7733 East Jefferson Ave, Detroit, MI 48214 2008-08-13
1639330210 Nicole Lashawn Greene Specialist 4533 St Clair St, Detroit, MI 48214 2008-06-17
1629299433 Alan R Faber Jr. Dentist 8191 E Jefferson Ave, Detroit, MI 48214 2007-05-01
1518188598 Mary F Bridges Psychiatry & Neurology 8120 East Jefferson #3l, Detroit, MI 48214 2007-05-01
1053439737 Geraldine Etella Davis Counselor 3840 Fairview St., Detroit, MI 48214 2007-03-27
1639203482 Detroit-macomb Hospital Corporation Advanced Practice Midwife 7815 E. Jefferson, Detroit, MI 48214 2007-03-15
1033275441 Anesha Amor Rouse Physical Therapy Assistant 7633 E. Jefferson Ave, Suite 170, Detroit, MI 48214 2006-12-29
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194354811 Lorie Ann Turner Family Medicine 1728 Sheridan St, Detroit, MI 48214-2410 2020-04-04
1134787633 Behavioral Health Professionals, Inc Family Medicine 19750 Burt Road, Detroit, MI 48219 2019-05-31
1508326687 Randi Nguyen Family Medicine 22151 Moross Rd Ste 212, Detroit, MI 48236-2177 2019-03-23
1982194338 Green Cross Medical Center PC Family Medicine 18041 Greenfield Rd, Detroit, MI 48235-3120 2018-05-11
1205339306 Conant Family Care Pllc Family Medicine 3611 Carpenter St Ste 5, Detroit, MI 48212-2784 2018-03-14
1801303086 St Mary Mercy Physician Practices Family Medicine 5555 Conner St Ste 2691, Detroit, MI 48213-3812 2018-01-09
1427408376 Raquel Orlich Family Medicine 1620 Michigan Ave Ste 125, Detroit, MI 48216-1493 2016-06-21
1295181543 Ammar Charestan Family Medicine 6071 Outer Dr W, Detroit, MI 48235 2016-05-05
1629423652 Rajni Parmar Family Medicine 6001 W Outer Dr Ste 430, Detroit, MI 48235-2626 2016-04-27
1265886733 Benjamin Abraham Family Medicine One Ford Place 2e, Henry Ford Hospital, Department of Family Medicine, Detroit, MI 48202 2016-04-20
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Competitor

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City DETROIT
Zip Code 48214

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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