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Individual

PRAVEEN K REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
721 RIVER DR., SUITE B, FORT BRAGG, CA 95437-5403
(707) 964-6910
(707) 964-7430
Mailing address
721 RIVER DR., SUITE B, FORT BRAGG, CA 95437-5403
(707) 964-6910
(707) 964-7430

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C142043
CA
207X00000X
Orthopaedic Surgery Physician
H6536
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115606901
TX
Enumeration date
01/25/2006
Last updated
10/06/2016
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