Individual
MR. BALI REDDY SODAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
24723
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200074670A
—
OK
Enumeration date
08/16/2006
Last updated
12/08/2010
Update your record
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