Individual
NAGIREDDY KAMIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96 MANSFIELD AVE, WILLIMANTIC, CT 06226-2091
(860) 450-7583
Mailing address
96 MANSFIELD AVE, WILLIMANTIC, CT 06226-2091
(860) 450-7583
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24233
CT
207RP1001X
Pulmonary Disease Physician
Primary
024233
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001242338
—
CT
Enumeration date
10/03/2005
Last updated
01/04/2015
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