Provider Demographics
NPI:1568705135
Name:REDDY, MALINI KANCHARLA (MD)
Entity Type:Individual
Prefix:DR
First Name:MALINI
Middle Name:KANCHARLA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1061 DOWDY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5700
Mailing Address - Country:US
Mailing Address - Phone:706-621-7575
Mailing Address - Fax:706-621-7557
Practice Address - Street 1:1061 DOWDY RD
Practice Address - Street 2:STE 100
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-621-7575
Practice Address - Fax:706-621-7557
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2018-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA076926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine