Provider Demographics
NPI:1629430434
Name:REDDY, NAMRATHA (MD)
Entity Type:Individual
Prefix:MS
First Name:NAMRATHA
Middle Name:
Last Name:REDDY
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 1:225 WILLIFORD ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3223
Mailing Address - Country:US
Mailing Address - Phone:913-961-5457
Mailing Address - Fax:
Practice Address - Street 1:225 WILLIFORD ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3223
Practice Address - Country:US
Practice Address - Phone:913-961-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS27002207R00000X
ARE-14092207R00000X
TN58975207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine