Provider Demographics
NPI:1891480448
Name:GUDIGOPURAM, SRI VALLABH REDDY (MD)
Entity Type:Individual
Prefix:
First Name:SRI VALLABH REDDY
Middle Name:
Last Name:GUDIGOPURAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8-5-32/12, ROAD NO: 1
Mailing Address - Street 2:SRINIDHI COLONY, KARMANGHAT
Mailing Address - City:HYDERABAD
Mailing Address - State:TELANGANA
Mailing Address - Zip Code:500079
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5001 HARDY STREET, MERIT HEALTH WESLEY
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:601-296-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program