Individual
VENKATA RAVI KIRAN KADIPI REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2793 LINEVILLE ROAD, GREEN BAY, WI 54307
(920) 496-4700
(920) 496-4704
Mailing address
2793 LINEVILLE ROAD, P O BOX 19070, GREEN BAY, WI 54307
(920) 496-4700
(920) 496-4704
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2007012349
MO
207Q00000X
Family Medicine Physician
Primary
54108-020
WI
Other
Enumeration date
08/07/2007
Last updated
03/28/2012
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