Provider Demographics
NPI:1447606488
Name:MANCHIREDDY, BRINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:BRINDA
Middle Name:
Last Name:MANCHIREDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SAM PERRY BLVD #305
Mailing Address - Street 2:
Mailing Address - City:FREDRICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401
Mailing Address - Country:US
Mailing Address - Phone:540-374-3290
Mailing Address - Fax:540-374-3289
Practice Address - Street 1:1101 SAM PERRY BLVD #305
Practice Address - Street 2:
Practice Address - City:FREDRICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-374-3290
Practice Address - Fax:540-374-3289
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101271645207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program