Individual
DR. ADHVITH REDDIVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 296-3963
Mailing address
10589 WILLOW BROOK RD, DAYTON, OH 45458-4738
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28283
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
01/25/2022
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