Provider Demographics
NPI:1700203338
Name:KURUVALLI, RENUKA REDDY (MD)
Entity Type:Individual
Prefix:
First Name:RENUKA REDDY
Middle Name:
Last Name:KURUVALLI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:C/O N KRISHNA REDDY, S3 ESSARDE ARCADE, PLOT NO 135
Mailing Address - Street 2:ROAD NO 4, EAST KAKATIYA NAGAR, NEREDMET,
Mailing Address - City:HYDERABAD
Mailing Address - State:A.P
Mailing Address - Zip Code:500056
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:ORTHOPAEDIC AND REHABILITAION DEPARTMENT
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-8991
Practice Address - Fax:503-494-5050
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORFE166260207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine