Provider Demographics
NPI:1689751448
Name:REDDY, PUTLUR R (MD)
Entity Type:Individual
Prefix:DR
First Name:PUTLUR
Middle Name:R
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 1:2106 COLEMAN PL
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-3840
Mailing Address - Country:US
Mailing Address - Phone:252-452-5463
Mailing Address - Fax:
Practice Address - Street 1:300 N GREEN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3325
Practice Address - Country:US
Practice Address - Phone:800-735-6296
Practice Address - Fax:800-735-6278
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21436207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine