Provider Demographics
NPI:1407424302
Name:REDDY, SUJANA (DO)
Entity type:Individual
Prefix:DR
First Name:SUJANA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 CATHERINE CT STE 1A
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5790
Mailing Address - Country:US
Mailing Address - Phone:334-501-1081
Mailing Address - Fax:334-501-1083
Practice Address - Street 1:1702 CATHERINE CT STE 1A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5790
Practice Address - Country:US
Practice Address - Phone:334-501-1081
Practice Address - Fax:334-501-1083
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL390200000X
ALDO.3027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program