Provider Demographics
NPI:1417196668
Name:M P REDDY MD INC
Entity Type:Organization
Organization Name:M P REDDY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARPADGA
Authorized Official - Middle Name:P
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-541-0342
Mailing Address - Street 1:1728 CHASE AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223
Mailing Address - Country:US
Mailing Address - Phone:513-541-0342
Mailing Address - Fax:513-541-5975
Practice Address - Street 1:1728 CHASE AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223
Practice Address - Country:US
Practice Address - Phone:513-541-0342
Practice Address - Fax:513-541-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-037848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276642Medicaid
OH0276642Medicaid
OHD31125Medicare UPIN