Provider Demographics
NPI:1871016832
Name:ANANT, KEDAARI REDDY (MD)
Entity Type:Individual
Prefix:
First Name:KEDAARI
Middle Name:REDDY
Last Name:ANANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KEDAARI
Other - Middle Name:ANANT
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:454 OLD STREET RD STE 301
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1200
Mailing Address - Country:US
Mailing Address - Phone:603-924-4680
Mailing Address - Fax:603-924-4977
Practice Address - Street 1:454 OLD STREET RD STE 301
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1200
Practice Address - Country:US
Practice Address - Phone:603-924-4680
Practice Address - Fax:603-924-4977
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH22283207RG0300X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program