Individual
GAYATHRI M REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9300 DEWITT LOOP, EAGLE PAVILION, FIRST FLOOR, FORT BELVOIR, VA 22060-5285
(571) 231-1803
(571) 231-6617
Mailing address
9300 DEWITT LOOP, EAGLE PAVILION, FIRST FLOOR, FORT BELVOIR, VA 22060-5285
(571) 231-1803
(571) 231-6617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101240383
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101240383
VA STATE LICENSE
VA
01
—
P00363727
MEDICARE RR
—
Enumeration date
08/03/2006
Last updated
05/17/2024
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