Provider Demographics
NPI:1750644944
Name:BHOGIREDDY, VARIJA (MD)
Entity Type:Individual
Prefix:
First Name:VARIJA
Middle Name:
Last Name:BHOGIREDDY
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 1:3558 SENECA FOREST DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-4500
Mailing Address - Country:US
Mailing Address - Phone:773-412-3930
Mailing Address - Fax:
Practice Address - Street 1:7370 N PALM AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5782
Practice Address - Country:US
Practice Address - Phone:559-228-4245
Practice Address - Fax:559-228-4299
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA137452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program