Individual
BALEED VISHNU VARDHAN REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
16557
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000084769
BLUE CROSS
AL
05
—
000084769
—
AL
01
—
00124571
MISSISSIPPI MEDICAID
MS
05
—
009937221
—
AL
01
—
010033CF43756
SECTION 1011
AL
01
—
051534744
BLUE CROSS
AL
01
—
12549
HEALTHSPRING OF ALABAMA
AL
01
—
1595110
EMERGENCY LA MEDICAID
LA
01
—
220010596
RAILROAD MEDICARE
AL
01
—
F43756
VIVA
AL
Enumeration date
07/10/2006
Last updated
11/14/2019
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