Provider Demographics
NPI:1487628483
Name:REDDY, BYRA M (MD)
Entity Type:Individual
Prefix:
First Name:BYRA
Middle Name:M
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:49 S CASS ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-2331
Mailing Address - Country:US
Mailing Address - Phone:269-969-8920
Mailing Address - Fax:269-969-8921
Practice Address - Street 1:3906 STONEGATE PARK
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9145
Practice Address - Country:US
Practice Address - Phone:269-428-0002
Practice Address - Fax:269-428-0019
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MIBR073619207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH36348Medicare UPIN
MIP14130001Medicare ID - Type Unspecified