MEDICARE: PRANAV REDDY DONAPATI

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1811786411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRANAV REDDY DONAPATI

Provider Business Mailing Address
First Line	:	8595 PICARDY AVENUE
Second Line	:	SUITE 400
City	:	BATON ROUGE
State	:	LA
Zip	:	70809
Country	:	US
Telephone Number	:	225-819-1129
Fax Number	:	225-442-5128

Provider Business Practice Location Address
First Line	:	3401 NORTH BOULEVARD, BRG MID CITY MEDICINE CLINIC
Second Line	:	SUITE 130
City	:	BATON ROUGE
State	:	LA
Zip	:	70806
Country	:	US
Telephone Number	:	225-387-7900
Fax Number	:

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

Provider Enumeration Date	:	05/01/2025
Last Update Date	:	01/28/2026

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Directions to “ PRANAV REDDY DONAPATI ” Practice Location

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