MEDICARE: DR. MURALIDHAR REDDY GUDDETI 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
1	208600000X	Surgery Physician	MD445282	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD445282	OTHER	PA	LICENCE

General Provider Information

NPI Number	:	1558525345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MURALIDHAR REDDY GUDDETI M.D

Provider Business Mailing Address
First Line	:	640 KOLTER DR
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3570
Country	:	US
Telephone Number	:	724-357-7196
Fax Number	:	724-357-7279

Provider Business Practice Location Address
First Line	:	841 HOSPITAL RD STE 2300
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3699
Country	:	US
Telephone Number	:	724-349-7820
Fax Number	:	724-349-8816

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

Provider Enumeration Date	:	07/11/2008
Last Update Date	:	03/26/2021

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Directions to “ DR. MURALIDHAR REDDY GUDDETI M.D” Practice Location

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