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NPI Code Detail

MEDICARE: DR. VIVEK K REDDY M.D.

MEDICARE: DR. VIVEK K REDDY M.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
12084V0102XVascular Neurology PhysicianMD431618PA
22084V0102XVascular Neurology Physician10270094-1205UT
32084N0400XNeurology Physician10270094-1205UT

General Provider Information

NPI Number : 1437376571
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIVEK K REDDY M.D.
Provider Business Mailing Address
First Line : 175 N MEDICAL DRIVE EAST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84132-0001
Country : US
Telephone Number : 801-585-7575
Fax Number :
Provider Business Practice Location Address
First Line : 175 N MEDICAL DRIVE EAST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84132-5705
Country : US
Telephone Number : 801-585-7575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 11/10/2025

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