Provider Demographics
NPI:1225140809
Name:MUNAGALA VENKATA, SUNDARA RAMESHWAR REDDY (MD)
Entity Type:Individual
Prefix:
First Name:SUNDARA RAMESHWAR
Middle Name:REDDY
Last Name:MUNAGALA VENKATA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SUNDARA
Other - Middle Name:
Other - Last Name:MUNAGALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:701 10TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1251
Mailing Address - Country:US
Mailing Address - Phone:319-369-4777
Mailing Address - Fax:319-369-4694
Practice Address - Street 1:701 10TH ST SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1251
Practice Address - Country:US
Practice Address - Phone:319-369-4777
Practice Address - Fax:319-369-4694
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA388222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry