Individual
BHASKER REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1115 N RONALD REAGAN PARKWAY, SUITE 206, AVON, IN 46123-6911
(317) 272-8050
(317) 272-8051
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01046775A
IN
208M00000X
Hospitalist Physician
01046775A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000668271
ANTHEM PTAN
IN
01
—
1102234516
ANTHEM PTAN
IN
05
—
200202940
—
IN
01
—
267030VV
MEDICARE PTAN
IN
Enumeration date
10/06/2005
Last updated
03/04/2025
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