Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 35925 | AZ |
NPI | 1003875451 |
---|---|
Provider Name | Naveen Reddy |
First Address | Scottsdale, AZ 85261-6104 |
Second Address | Chandler, AZ 85286-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137688 | (05) | AZ |
I49131 | (02) |