Provider Demographics
NPI:1659707479
Name:MARTHA, VISHNU VARDHAN REDDY (M'BBS,MS,DNB, PHD)
Entity Type:Individual
Prefix:DR
First Name:VISHNU
Middle Name:VARDHAN REDDY
Last Name:MARTHA
Suffix:
Gender:M
Credentials:M'BBS,MS,DNB, PHD
Other - Prefix:DR
Other - First Name:VISHNU
Other - Middle Name:VARDHAN REDDY
Other - Last Name:MARTHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:219 N BROAD ST FL 10
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program