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Individual

PESARA P REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2500 W 12TH ST, THE REGIONAL CANCER CTR, ERIE, PA 16505
(814) 835-9000
(814) 838-0443
Mailing address
2500 W 12TH ST, THE REGIONAL CANCER CTR, ERIE, PA 16505
(814) 835-9000
(814) 838-0443

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD034289L
PA
2085R0203X
Therapeutic Radiology Physician
MD034289L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006903140001
PA
05
2193611
OH
Enumeration date
02/13/2006
Last updated
03/31/2010
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