Healthcare Provider Details

I. General information

NPI: 1518965094
Provider Name (Legal Business Name): NAGA PRASUNA MADIREDDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 S MASON MONTGOMERY RD
MASON OH
45040-3706
US

IV. Provider business mailing address

6030 S MASON MONTGOMERY RD
MASON OH
45040-3706
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-204-6355
Mailing address:
  • Phone: 513-246-7000
  • Fax: 513-204-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35081903
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: