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Individual

MR. PULI PRAVIN REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1418 DRESDEN DRIVE, 120, ATLANTA, GA 30319
(404) 481-5089
(404) 795-0461
Mailing address
1418 DRESDEN DRIVE, SUITE 120, ATLANTA, GA 30319
(404) 481-5089
(404) 795-0461

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
240739
NY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
046220
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TAX ID
26-3609921
GA
Enumeration date
11/20/2007
Last updated
04/12/2018
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