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General NPI Number Information
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NPI Number | 1508898818
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Entity Type | Individual
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Provider Name | CHANDRASHEKARA REDDY MD PHD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 750 S CHURCH ST
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City | SPARTANBURG
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State | SC
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Zip | 29306-5348
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Country | US
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Telephone | 864-582-2411
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Fax | 864-582-7178
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Provider Business Mailing Address
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Address Line | 750 S CHURCH ST
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City | SPARTANBURG
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State | SC
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Zip | 29306-5348
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Country | US
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Telephone | 864-582-2411
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Fax | 864-582-7178
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD00043121
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 47052-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 83642
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License Number State | SC
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