Provider Demographics
NPI:1013992304
Name:REDDY, GANGA SOMASHEKAR (MD)
Entity Type:Individual
Prefix:
First Name:GANGA
Middle Name:SOMASHEKAR
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:952-595-6455
Practice Address - Street 1:5100 GAMBLE DR STE 100 - MAIL STOP 31200A
Practice Address - Street 2:HEALTHPARTNERS WEST CLINIC
Practice Address - City:ST. LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1582
Practice Address - Country:US
Practice Address - Phone:952-541-2500
Practice Address - Fax:952-595-6455
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2011-12-14
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Provider Licenses
StateLicense IDTaxonomies
MN47449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN812084600Medicaid
MN812084600Medicaid
MN110010175Medicare ID - Type Unspecified