Healthcare Provider Details

I. General information

NPI: 1598469918
Provider Name (Legal Business Name): MALIPEDDI NAGENDRA K REDDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 NORTH BLVD STE 130
BATON ROUGE LA
70806-3743
US

IV. Provider business mailing address

7373 PERKINS RD
BATON ROUGE LA
70808-4373
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-7900
  • Fax:
Mailing address:
  • Phone: 225-246-9790
  • Fax: 225-763-4549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number351307
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: