Individual
DR. KALYAN CHAKRAVARTHY DADIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0846
(352) 273-8670
Mailing address
PO BOX 100138, GAINESVILLE, FL 32610-0138
(352) 273-8670
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
126832
OH
208200000X
Plastic Surgery Physician
54391
TN
208200000X
Plastic Surgery Physician
Primary
ME155911
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
ME155911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09037091
—
MS
05
—
1760823595
—
MO
05
—
223093001
—
AR
05
—
Q030638
—
TN
Enumeration date
07/09/2013
Last updated
10/25/2022
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