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General NPI Number Information
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NPI Number | 1689024945
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Entity Type | Individual
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Provider Name | PAVAN G REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 08/14/2022
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER DR
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City | SPRINGFIELD
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State | OH
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Zip | 45504-2687
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Country | US
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Telephone | 330-994-4323
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Fax | 330-409-8871
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Provider Business Mailing Address
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Address Line | 100 MEDICAL CENTER DR
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City | SPRINGFIELD
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State | OH
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Zip | 45504-2687
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Country | US
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Telephone | 330-994-4323
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Fax | 803-434-4183
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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 | 35.145175
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License Number State | OH
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