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Individual

SUBHASH K REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7806 W JEFFERSON BLVD STE D, FORT WAYNE, IN 46804-4180
(260) 432-7000
(260) 459-6625
Mailing address
7806 W JEFFERSON BLVD STE D, FORT WAYNE, IN 46804-4180
(260) 432-7000
(260) 459-6625

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01040891
IN
207RC0000X
Cardiovascular Disease Physician
35069550
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000087404
ANTHEM
IN
05
0913293
OH
05
100095070
IN
01
110070256
RAILROAD
01
RE0797831
MEDICARE-PAULDING
OH
01
RE0797832
MEDICARE-VANWERT
OH
Enumeration date
01/25/2006
Last updated
07/23/2025
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