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NPI Code Detail

MEDICARE: SRINIVASA REDDY REDDY M.D.

MEDICARE: SRINIVASA REDDY REDDY M.D.
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
12084P0800XPsychiatry Physician30403SC

General Provider Information

NPI Number : 1356437743
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRINIVASA REDDY REDDY M.D.
Provider Business Mailing Address
First Line : 7901 FARROW RD
Second Line : SOUTH CAROLINA DEPT. OF MENTAL HEALTH
City : COLUMBIA
State : SC
Zip : 29203-3220
Country : US
Telephone Number : 803-935-5746
Fax Number :
Provider Business Practice Location Address
First Line : 7901 FARROW RD
Second Line : SOUTH CAROLINA DEPT. OF MENTAL HEALTH
City : COLUMBIA
State : SC
Zip : 29203-3220
Country : US
Telephone Number : 803-935-5746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 04/08/2008

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Directions to “ SRINIVASA REDDY REDDY M.D.” Practice Location

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