Individual
DR. KAVITHA R REDDY
Active
Individual
DR. KAVITHA R REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301085040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-523-377-0
ECFMG #
—
01
—
142459
CARE CHOICES-PREFERRED
MI
01
—
17429
M-CARE
MI
01
—
2005005836
STATE LICENSE
MO
01
—
25050
BLUE CARE NETWORK
MI
05
—
4781201
—
MI
01
—
KR085040
BCBSM
MI
01
—
P00279740
RAILROAD MEDICARE
MI
Enumeration date
08/17/2005
Last updated
09/14/2020
Update your record
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