Provider Demographics
NPI:1821285784
Name:UPPU, AMBIKA (MD)
Entity Type:Individual
Prefix:
First Name:AMBIKA
Middle Name:
Last Name:UPPU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBIKA
Other - Middle Name:
Other - Last Name:HOSAKOTE-SUBRAHMANYAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7111 S. VIRGINIA SUITE A7
Mailing Address - Street 2:RENO FAMILY PHYSICIANS
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511
Mailing Address - Country:US
Mailing Address - Phone:775-851-5700
Mailing Address - Fax:775-851-5727
Practice Address - Street 1:7111 S. VIRGINIA SUITE A7
Practice Address - Street 2:RENO FAMILY PHYSICIANS
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511
Practice Address - Country:US
Practice Address - Phone:775-851-5700
Practice Address - Fax:775-851-5727
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13275207Q00000X
PAMT186808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine