Provider Demographics
NPI:1740277664
Name:REDDY, PALLAVY GOPAL (MD)
Entity type:Individual
Prefix:
First Name:PALLAVY
Middle Name:GOPAL
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7281 SAWMILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9021
Mailing Address - Country:US
Mailing Address - Phone:614-764-0707
Mailing Address - Fax:614-764-1707
Practice Address - Street 1:7281 SAWMILL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9021
Practice Address - Country:US
Practice Address - Phone:614-764-0707
Practice Address - Fax:614-764-1707
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085891207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRE4162371Medicare ID - Type Unspecified
H99788Medicare UPIN