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1356389118

NPI Code Detail

MEDICARE: DR. GADDUM P REDDY MD

MEDICARE: DR. GADDUM P 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	208600000X	Surgery Physician	7241	SD
2	208600000X	Surgery Physician	MD-56382	IA
3	208600000X	Surgery Physician	51246	MN
4	208600000X	Surgery Physician	R0486	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356389118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GADDUM P REDDY MD

Provider Business Mailing Address
First Line	:	2101 ELM ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2417
Country	:	US
Telephone Number	:	701-239-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 ELM ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2417
Country	:	US
Telephone Number	:	701-239-3700
Fax Number	:

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	05/19/2026

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Directions to “ DR. GADDUM P REDDY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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