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General NPI Number Information
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NPI Number | 1396809828
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Entity Type | Organization
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Legal Business Name | SAMYUKTHA C.REDDY,M.D.,P.C.
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 400 WHITESPORT DR SW SUITE 101
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6452
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Country | US
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Telephone | 256-885-2222
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Fax | 256-885-2223
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Provider Business Mailing Address
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Address Line | 400 WHITESPORT DR SW SUITE 101
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6452
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Country | US
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Telephone | 256-885-2222
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Fax | 256-885-2223
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMYUKTHA C REDDY
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Credential | M.D.
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Telephone | 256-885-2222
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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 | AL10773
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License Number State | AL
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