Healthcare Provider Details

I. General information

NPI: 1497749592
Provider Name (Legal Business Name): RAMANI B REDDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12126 HERITAGE PARK CIR
SILVER SPRING MD
20906-4554
US

IV. Provider business mailing address

1101 SNIDER LN
SILVER SPRING MD
20905-4135
US

V. Phone/Fax

Practice location:
  • Phone: 301-460-6646
  • Fax: 877-919-2471
Mailing address:
  • Phone: 301-384-2506
  • Fax: 301-460-7867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD33762
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101234079
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD0060089
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: