Provider Demographics
NPI:1487818670
Name:REDDY, NAVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NAVIN
Middle Name:
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 TAYLOR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5617
Mailing Address - Country:US
Mailing Address - Phone:202-464-9200
Mailing Address - Fax:202-207-0752
Practice Address - Street 1:1221 TAYLOR ST NW
Practice Address - Street 2:OUTPATIENT PSYCHIATRIC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5617
Practice Address - Country:US
Practice Address - Phone:202-464-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT04923286500000X, 282N00000X
DCMD041465282N00000X, 251S00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No286500000XHospitalsMilitary Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC057062300Medicaid