Individual
PRASHANT REDDY MUDIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
521 MOYE BLVD STE C3, GREENVILLE, NC 27834-2849
(252) 816-0800
Mailing address
51 NORTH 39TH STREET, PHILADELPHIA, PA 19104-2640
(215) 662-9436
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD433263
PA
207RG0100X
Gastroenterology Physician
Primary
2017-00725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102059064
—
PA
Enumeration date
07/02/2007
Last updated
01/13/2022
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