Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 4508 | AL |
NPI | 1487802609 |
---|---|
Provider Name | Krishna Paida Reddy |
First Address | Cropwell, AL 35054-5100 |
Second Address | Cropwell, AL 35054-5100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2008 |
Last Update Date | 29/08/2008 |