MEDICARE: TANUJA 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	2085R0202X	Diagnostic Radiology Physician	N3266	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	208D00000X	General Practice Physician	N3266	TX

General Provider Information

NPI Number	:	1356559587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANUJA REDDY MD

Provider Business Mailing Address
First Line	:	7881 GROVE CT E
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-3301
Country	:	US
Telephone Number	:	817-305-0190
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 MADISON AVE
Second Line	:	SUITE C50
City	:	MEMPHIS
State	:	TN
Zip	:	38103-3438
Country	:	US
Telephone Number	:	901-448-5364
Fax Number	:

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

Provider Enumeration Date	:	05/20/2007
Last Update Date	:	11/05/2023

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