Provider Demographics
NPI:1801193438
Name:REDDY, DEVARA RAJASEKHAR (MD)
Entity type:Individual
Prefix:DR
First Name:DEVARA
Middle Name:RAJASEKHAR
Last Name:REDDY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3901 RAINBOW BLVD, 4070 DELP, MS 4017
Mailing Address - Street 2:KANSAS UNIVERSITY PHYSICIANS INC.
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-2501
Mailing Address - Fax:913-588-3877
Practice Address - Street 1:3901 RAINBOW BLVD, 6040 DELP, MS 1020
Practice Address - Street 2:DIVISION OF GENERAL AND GERIATRIC MEDICINE, UNIVERSITY
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6005
Practice Address - Fax:913-588-3877
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2017-10-13
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Provider Licenses
StateLicense IDTaxonomies
KS04-38902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1801193438Medicaid
MOPENDINGMedicare PIN