Individual
DR. REVATI BHASKER REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MSC10 5550 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-4661
Mailing address
MSC10 5550 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2022-0564
NM
207R00000X
Internal Medicine Physician
ME138137
FL
208M00000X
Hospitalist Physician
ME138137
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104342400
—
FL
01
—
9S27J
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/23/2016
Last updated
08/22/2023
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