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NPI 1023005840

NPI 1023005840 : BHASKER REDDY MD : AVON, IN

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General NPI Number Information
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    NPI Number           |    1023005840
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    Entity Type          |    Individual 
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    Provider Name        |    BHASKER REDDY MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/06/2005
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    Last Update Date     |    03/04/2025
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Provider Practice Location Address
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    Address Line         |    1115 N RONALD REAGAN PARKWAY SUITE 206
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    City                 |    AVON
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    State                |    IN
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    Zip                  |    46123-6911
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    Country              |    US
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    Telephone            |    317-272-8050
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    Fax                  |    317-272-8051
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Provider Business Mailing Address
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    Address Line         |    250 N SHADELAND AVE 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46219-4959
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    01046775A
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    License Number State |    IN
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Taxonomy #2
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    01046775A
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    License Number State |    IN
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