MEDICARE: DR. ARCHANA 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
1	207RC0000X	Cardiovascular Disease Physician	0101249684	VA

General Provider Information

NPI Number	:	1639332737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARCHANA REDDY M.D

Provider Business Mailing Address
First Line	:	PO BOX 37174
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-3174
Country	:	US
Telephone Number	:	703-780-9014
Fax Number	:	703-780-9077

Provider Business Practice Location Address
First Line	:	8101 HINSON FARM ROAD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3409
Country	:	US
Telephone Number	:	703-780-9014
Fax Number	:	703-780-9077

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

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	11/27/2023

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