Provider Demographics
NPI:1871234716
Name:GINNARAM, AKHILESHWAR REDDY (MBBS)
Entity Type:Individual
Prefix:DR
First Name:AKHILESHWAR
Middle Name:REDDY
Last Name:GINNARAM
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 N YORK RD APT 400-44
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2156
Mailing Address - Country:US
Mailing Address - Phone:508-475-9996
Mailing Address - Fax:
Practice Address - Street 1:4301 WEST MARKHAM
Practice Address - Street 2:SLOT 556
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:556-603-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program