Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 052981 | CT |
Y | 207RR0500X | Rheumatology | 2021-01858 | NC |
NPI | 1093944001 |
---|---|
Provider Name | Dr. Ranadeep Reddy Mandhadi |
First Address | Atlanta, GA 30374-4786 |
Second Address | Gastonia, NC 28054-2183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2009 |
Last Update Date | 30/11/2021 |