Individual
JYOTHSNA M REDDY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5502 W BROADWAY AVE, CRYSTAL, MN 55428-3508
(763) 287-6543
(763) 287-6544
Mailing address
5502 W BROADWAY AVE, CRYSTAL, MN 55428-3508
(763) 287-6543
(763) 287-6544
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34539
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4640000400
—
MN
Enumeration date
11/03/2005
Last updated
07/08/2007
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