Healthcare Provider Details

I. General information

NPI: 1902136914
Provider Name (Legal Business Name): MURALIDHAR REDDY PAPIREDDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 N RUTLEDGE ST STE 1100
SPRINGFIELD IL
62702-4968
US

IV. Provider business mailing address

329 N STATE OF FRANKLIN RD
JOHNSON CITY TN
37604-6062
US

V. Phone/Fax

Practice location:
  • Phone: 217-545-0182
  • Fax: 217-545-4735
Mailing address:
  • Phone: 423-979-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number66240
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036125781
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number66240
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME150485
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number66240
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME150485
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036125781
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: