Provider Demographics
NPI:1598343857
Name:TATAGARI, VISHWANT REDDY (DO)
Entity type:Individual
Prefix:MR
First Name:VISHWANT
Middle Name:REDDY
Last Name:TATAGARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE ST BOX 801008
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-243-5676
Mailing Address - Fax:434-243-5689
Practice Address - Street 1:1215 LEE ST BOX 801008
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-243-5676
Practice Address - Fax:434-243-5689
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program