Individual
DR. SUDHAKAR REDDY MORTHALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2171 HIGHWAY 1 S, ELGIN, SC 29045-9051
(803) 438-0455
(803) 438-0457
Mailing address
2171 HIGHWAY 1 S, ELGIN, SC 29045-9051
(803) 438-0455
(803) 438-0457
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28478
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2028478
SC CONTROLLED DRUG PERMIT
SC
01
—
28478
MEDICAL LICENSE
SC
Enumeration date
07/28/2006
Last updated
03/07/2023
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