MEDICARE: ARJUN CHENNA REDDY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	60 266653	NY
2	207L00000X	Anesthesiology Physician	MD-17660	HI
3	207L00000X	Anesthesiology Physician	61243386	WA

General Provider Information

NPI Number	:	1033371901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARJUN CHENNA REDDY MD

Provider Business Mailing Address
First Line	:	909 SQUALICUM WAY STE 102
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-2077
Country	:	US
Telephone Number	:	606-473-3773
Fax Number	:	360-752-3214

Provider Business Practice Location Address
First Line	:	909 SQUALICUM WAY STE 102
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-2077
Country	:	US
Telephone Number	:	606-473-3773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	03/03/2023

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