Individual
NAGENDRA PRASAD REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
894 E 3900 S, #B, SALT LAKE CITY, UT 84107-2151
(866) 500-7071
(866) 500-7081
Mailing address
PO BOX 9677, SALT LAKE CITY, UT 84109-9677
(866) 500-7071
(866) 500-7081
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005020847
MO
207R00000X
Internal Medicine Physician
6369024-1205
UT
208M00000X
Hospitalist Physician
Primary
6369024-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208331801
—
MO
01
—
6369024-1205
UTAH DOPL
UT
01
—
6369024-8905
UTAH DOPL CS
UT
Enumeration date
03/29/2006
Last updated
03/26/2015
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