Individual
DR. MADAN MOHAN GANGAPURAM REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 KY HIGHWAY 36 E STE 1D, CYNTHIANA, KY 41031-7490
(859) 234-1707
(859) 234-1768
Mailing address
1210 KY HIGHWAY 36 E STE G3, CYNTHIANA, KY 41031-7498
(859) 234-3605
(859) 234-5666
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
24976
WV
207X00000X
Orthopaedic Surgery Physician
Primary
48934
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
105688
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100227130
—
KY
Enumeration date
08/10/2011
Last updated
03/17/2018
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