Provider Demographics
NPI:1003916248
Name:VALLAPU REDDY, HEMANTH KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:HEMANTH
Middle Name:KUMAR
Last Name:VALLAPU REDDY
Suffix:
Gender:M
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:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9102
Practice Address - Street 1:3311 E MURDOCK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3054
Practice Address - Country:US
Practice Address - Phone:316-689-9335
Practice Address - Fax:620-694-4512
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25750207R00000X
CAC52736207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100175170BMedicaid
KS100175170AMedicaid
TX358630YMSKMedicare PIN
G06243Medicare UPIN
KS106498Medicare PIN
KS100175170AMedicaid