Individual
PALLAVI REDDY KUPPIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 GRESHAM DR FL 5, NORFOLK, VA 23507-1904
(757) 388-3198
(757) 388-4242
Mailing address
600 GRESHAM DR FL 5, NORFOLK, VA 23507-1904
(757) 388-3198
(757) 388-4242
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101253180
VA
208M00000X
Hospitalist Physician
0101253180
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-028
TRICARE/CHAMPUS
VA
01
—
10109990
OPTIMA HEALTH
VA
01
—
1568776540
VIRGINIA PREMIER HEALTH PLAN
VA
05
—
1568776540
—
NC
05
—
1568776540
—
VA
01
—
494178
ANTHEM BC/BS
VA
01
—
PAR
USA MANAGED CARE
VA
Enumeration date
08/02/2010
Last updated
01/15/2020
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