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Individual

DR. CHETANA M REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5380
(314) 268-4141
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5380
(314) 268-4141

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
066403
GA
2080P0202X
Pediatric Cardiology Physician
Primary
2006008763
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003114510C
GA
05
203737200
MO
05
250358060
IL
Enumeration date
07/25/2006
Last updated
03/09/2021
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