Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jaya Raghu Teja Teja Gadivemula, MD

Individual provider Internal Medicine Physician · NPI 1639551039

Dr. Jaya Raghu Teja Teja Gadivemula, MD is an Internal Medicine in Detroit, Michigan. Qualified in 2007, 19 years ago. Practices with Coolidge Physician Services LLC, a 51-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
19
Licensed in
LA
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4201 St Antoine Ste 2E
Detroit, MI 48201
Phone: (313) 745-4525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 321436 (LA)

Record details

NPI number1639551039
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 22, 2015
Last updated in NPPESDecember 30, 2019
Certification dateDecember 30, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Coolidge Physician Services Llc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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