Individual
DR. AJAY REDDIVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1380 E STROOP RD, KETTERING, OH 45429-4926
(937) 294-4356
(937) 297-2381
Mailing address
1380 E STROOP RD, KETTERING, OH 45429-4926
(937) 294-4356
(937) 297-2381
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35-06-0503R
OH
207RI0011X
Interventional Cardiology Physician
Primary
35060503
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0941600
—
OH
Enumeration date
11/16/2005
Last updated
01/04/2021
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