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General NPI Number Information
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NPI Number | 1760611776
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Entity Type | Individual
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Provider Name | VISHNU VARDHAN REDDY NARAVADI M.D
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Gender | Male
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Dates
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Enumeration Date | 07/11/2009
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 2930 CHESTERFIELD AVE
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City | CHARLESTON
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State | WV
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Zip | 25304-1125
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Country | US
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Telephone | 304-351-1700
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Fax | 304-351-1725
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Provider Business Mailing Address
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Address Line | 3110 MACCORKLE AVE SE
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City | CHARLESTON
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State | WV
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Zip | 25304-1210
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Country | US
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Telephone | 304-347-1254
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Fax | 304-347-1291
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036130658
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 29606
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License Number State | WV
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