MEDICARE: SATYANARAYAN 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
1	207RH0003X	Hematology & Oncology Physician	36261	GA
2	207RX0202X	Medical Oncology Physician	036261	GA
3	207RH0003X	Hematology & Oncology Physician	036261	GA

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	:	1831192236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SATYANARAYAN K REDDY M.D.

Provider Business Mailing Address
First Line	:	19652 GROVER ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-5042
Country	:	US
Telephone Number	:	404-822-3022
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 WOOLWORTH AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-1850
Country	:	US
Telephone Number	:	404-822-3022
Fax Number	:

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/12/2023

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