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Individual

RAJESH REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2499
(808) 691-1000
Mailing address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2499
(808) 691-1000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-23424
HI
207Q00000X
Family Medicine Physician
P0476
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202I081106
MEDICARE - URGENTONE
GA
01
202I086009
MEDICARE - MPPG
GA
01
52320665-003
BCBS/SAVANNAH
GA
01
52320665-004
BCBS/POOLER
GA
01
842370942A
MEDICAID - MPPG/1107 EAST 66TH
GA
01
842370942B
MEDICAID - URGENTONE POOLER
GA
01
842370942C
MEDICAID - URGENTONE SAVANNAH
GA
01
842370942D
MEDICAID - MPPG/POOLER
GA
05
842370942E
GA
05
G63010
SC
01
P00761167
RR MEDICARE FOR MPPG
GA
01
P00829211
RR MEDICARE FOR URGENTONE
GA
Enumeration date
08/22/2007
Last updated
05/04/2023
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