MEDICARE: DR. RAMANI MAJJICA REDDY M.D., PH. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	27997	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417955154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMANI MAJJICA REDDY M.D., PH. D.

Provider Business Mailing Address
First Line	:	PO BOX 440332
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0332
Country	:	US
Telephone Number	:	865-670-6199
Fax Number	:	865-670-6198

Provider Business Practice Location Address
First Line	:	689 MEDICAL PARK DR
Second Line	:	STE 301
City	:	LENOIR CITY
State	:	TN
Zip	:	37772-5795
Country	:	US
Telephone Number	:	865-988-6330
Fax Number	:	865-988-8772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	02/11/2013

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