MEDICARE: DR. GOPAL B 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
1	207RI0200X	Infectious Disease Physician	D0053870	MD
2	207RI0200X	Infectious Disease Physician	D0053670	MD

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588758874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GOPAL B REDDY M.D.

Provider Business Mailing Address
First Line	:	3107 WYNFORD DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-2825
Country	:	US
Telephone Number	:	443-646-5001
Fax Number	:	410-257-7042

Provider Business Practice Location Address
First Line	:	11890 HEALING WAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7917
Country	:	US
Telephone Number	:	443-964-5950
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	04/24/2025

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Directions to “ DR. GOPAL B REDDY M.D.” Practice Location

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