Provider Demographics
NPI:1801258207
Name:REDDY, SHRENIKA GUNUKULA (MD)
Entity type:Individual
Prefix:DR
First Name:SHRENIKA
Middle Name:GUNUKULA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SRI SHRENIKA SHOURIE
Other - Middle Name:
Other - Last Name:EDLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:1400 US HIGHWAY 61 STE 210
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4141
Mailing Address - Country:US
Mailing Address - Phone:636-933-8880
Mailing Address - Fax:
Practice Address - Street 1:1400 US HIGHWAY 61 STE 210
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4141
Practice Address - Country:US
Practice Address - Phone:636-933-8880
Practice Address - Fax:636-933-8881
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021046251207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty