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Individual

DR. NITYA M REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MBBS

Contact information

Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 535-0191
(770) 535-0916
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
000485
GA
208M00000X
Hospitalist Physician
061151
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01310558
AMERIGROUP
GA
01
3422646
CIGNA
GA
01
515470
WELLCARE
GA
01
52318303
BCBS
GA
05
531391441A
GA
Enumeration date
05/03/2007
Last updated
03/07/2019
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