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General NPI Number Information
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NPI Number | 1366739625
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Entity Type | Individual
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Provider Name | GANGADASU REDDY MD, MS
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 601 N 30TH ST
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City | OMAHA
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State | NE
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Zip | 68131-2128
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Country | US
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Telephone | 402-717-0820
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Fax | 402-717-6061
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Provider Business Mailing Address
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Address Line | 7261 MERCY RD
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City | OMAHA
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State | NE
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Zip | 68124-2311
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Country | US
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Telephone | 402-398-6248
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Fax | 402-829-8513
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 27905
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 27905
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 27905
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License Number State | NE
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