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Individual
BALA SUDHAKAR REDDY ALLAM
Active
Individual
BALA SUDHAKAR REDDY ALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2010018938
MO
208M00000X
Hospitalist Physician
Primary
2010018938
MO
390200000X
Student in an Organized Health Care Education/Training Program
MT189901
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104024231
—
MO
05
—
183039001
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00852017
RAILROAD MEDICARE GROUP CB9013
—
Enumeration date
07/10/2007
Last updated
05/08/2017
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