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Individual

DR. SOMA NARASIMHA REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
8907 PERIWINKLE BLUE CT, LORTON, VA 22079-5700
(240) 210-1641
Mailing address
8907 PERIWINKLE BLUE CT, LORTON, VA 22079-5700
(240) 210-1641

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101025624
VA
208000000X
Pediatrics Physician
D17986
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036211500
MD
Enumeration date
06/16/2005
Last updated
01/09/2016
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