1902863384 NPI number — DR. SUBASHRI REDDY M.D.

Table of content: DR. SUBASHRI REDDY M.D. (NPI 1902863384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902863384 NPI number — DR. SUBASHRI REDDY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REDDY
Provider First Name:
SUBASHRI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUNDARARAJAN
Provider Other First Name:
SUBASHRI
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902863384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1325 PEPPERTREE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CROFTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21114-3269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 DEFENSE HWY
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
CROFTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21114-2926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-721-5280
Provider Business Practice Location Address Fax Number:
410-721-2243
Provider Enumeration Date:
04/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0058797 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0405217 . This is a "EVERCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521973185 . This is a "UNITED HEALTCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521973185 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 277779 . This is a "MAMSI/ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7690431 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0406167 . This is a "UNTD HLTHC AMERI CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521973185 . This is a "FIDELITY PMG" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 10136 . This is a "KAISER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 517676 . This is a "NCPPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 402797300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 521973185 . This is a "COVENTRY HLTH OF DELAWARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 61876602 . This is a "BCBS OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 67064000000 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 25970031 . This is a "BCBSNCA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 3022668 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 9716197001 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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