Provider Demographics
NPI:1841201175
Name:REDDY, VISHALA G (MD)
Entity Type:Individual
Prefix:
First Name:VISHALA
Middle Name:G
Last Name:REDDY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4791 BUCKINGHAM DR
Mailing Address - Street 2:4791
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2152
Mailing Address - Country:US
Mailing Address - Phone:440-562-2036
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-421-3015
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA052207207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy