Individual
CHAKRAVARTHY B REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26 N 1900 E, 701, WINTROBE BUILDING, SALT LAKE CITY, UT 84132-0002
(801) 581-7806
(801) 585-3355
Mailing address
4486 S GILEAD WAY, SALT LAKE CITY, UT 84124-4016
(801) 671-4803
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
52163851205
UT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
5216385-1205
UT
207RP1001X
Pulmonary Disease Physician
Primary
5216385-1205
UT
208M00000X
Hospitalist Physician
5216385-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508962176
—
UT
Enumeration date
09/14/2006
Last updated
11/12/2021
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