Provider Demographics
NPI:1164884896
Name:REDDY, CHANDRIKA
Entity Type:Individual
Prefix:
First Name:CHANDRIKA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 WASHINGTON ST STE 6100
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5901
Mailing Address - Country:US
Mailing Address - Phone:816-932-3470
Mailing Address - Fax:816-932-3437
Practice Address - Street 1:4321 WASHINGTON ST STE 6100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5901
Practice Address - Country:US
Practice Address - Phone:816-932-3470
Practice Address - Fax:816-932-3437
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8540207RE0101X
NY390200000X
MO2021023212207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program