Provider Demographics
NPI:1598820375
Name:REDDY, RAM N (MD)
Entity Type:Individual
Prefix:DR
First Name:RAM
Middle Name:N
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAM
Other - Middle Name:N
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:51342 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:ST CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950
Mailing Address - Country:US
Mailing Address - Phone:740-695-6500
Mailing Address - Fax:740-695-6502
Practice Address - Street 1:51342 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:ST CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-695-6500
Practice Address - Fax:740-695-6502
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041990208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0366689Medicaid
OH0366689Medicaid
OHRE0757872Medicare ID - Type Unspecified