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General NPI Number Information
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NPI Number | 1710045166
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Entity Type | Individual
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Provider Name | RAMACHANDRA V REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 701 SUPERIOR AVE
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City | MUNSTER
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State | IN
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Zip | 46321-4037
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Country | US
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Telephone | 219-924-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 1ST ST SUITE 703
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3200
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01066206A
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License Number State | IN
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