Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 232953 | MA |
N | 208600000X | Surgeon | 232953 | MA |
N | 208200000X | Surgeon | 29178 | WV |
N | 208600000X | Surgeon | 29178 | WV |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101258958 | VA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 232953 | MA |
NPI | 1053432856 |
---|---|
Provider Name | Shalini Rohini Reddy |
First Address | Winchester, VA 22601-2896 |
Second Address | Winchester, VA 22601-6906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 28/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2140471 | (05) | MA |