Individual
MADHAVI THUKIVAKAM REDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
33 EAST CHESTNUT AVENUE, PHILADELPHIA, PA 19118-2713
(215) 248-1350
Mailing address
33 EAST CHESTNUT AVENUE, PHILADELPHIA, PA 19118-2713
(215) 248-1350
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-116563
IL
207RC0000X
Cardiovascular Disease Physician
MD.201257
LA
207RC0000X
Cardiovascular Disease Physician
Primary
MD446760
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03672328
—
MS
05
—
1457558
—
LA
Enumeration date
01/17/2007
Last updated
10/17/2012
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