Provider Demographics
NPI:1861647208
Name:REDDY, NANDANA R (MD)
Entity Type:Individual
Prefix:DR
First Name:NANDANA
Middle Name:R
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NANDANA
Other - Middle Name:REDDY
Other - Last Name:RALLAPALLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2655 HERMITAGE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6337
Mailing Address - Country:US
Mailing Address - Phone:678-480-0861
Mailing Address - Fax:770-781-9680
Practice Address - Street 1:2655 HERMITAGE DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6337
Practice Address - Country:US
Practice Address - Phone:678-666-4430
Practice Address - Fax:678-666-4422
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine