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General NPI Number Information
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NPI Number | 1255754719
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Entity Type | Individual
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Provider Name | PHANINDAR REDDY SADHU MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 3903 FAIR RIDGE DR STE 218
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City | FAIRFAX
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State | VA
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Zip | 22033-2945
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Country | US
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Telephone | 703-870-3750
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Fax | 855-749-9998
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Provider Business Mailing Address
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Address Line | 3903 FAIR RIDGE DR STE 218
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City | FAIRFAX
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State | VA
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Zip | 22033-2945
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Country | US
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Telephone | 703-870-3750
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Fax | 855-749-9998
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2017-02030
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License Number State | NC
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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 | 0101268267
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License Number State | VA
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