Provider Demographics
NPI:1346530995
Name:REDDY, PRANAV KONUDULLA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANAV
Middle Name:KONUDULLA
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2295 S VINEYARD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7926
Mailing Address - Country:US
Mailing Address - Phone:909-724-2561
Mailing Address - Fax:909-724-2519
Practice Address - Street 1:2810 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4708
Practice Address - Country:US
Practice Address - Phone:612-873-3044
Practice Address - Fax:612-630-8242
Is Sole Proprietor?:No
Enumeration Date:2011-04-17
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
MN1346530995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine