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General NPI Number Information
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NPI Number | 1033379144
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Entity Type | Individual
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Provider Name | KUMUDA REDDY M.D
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Gender | Female
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 5009 PADUCAH RD
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City | COLLEGE PARK
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State | MD
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Zip | 20740-1133
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Country | US
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Telephone | 301-474-2184
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Fax |
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Provider Business Mailing Address
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Address Line | 5009 PADUCAH RD
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City | COLLEGE PARK
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State | MD
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Zip | 20740-1133
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Country | US
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Telephone | 301-474-2184
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101230524
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License Number State | VA
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