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Individual

MR. LAXMA REDDY MARRI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3606 S 4TH ST, TERRE HAUTE, IN 47802-5543
(812) 234-6977
(812) 234-7186
Mailing address
3606 S 4TH ST, TERRE HAUTE, IN 47802-5543
(812) 234-6977
(812) 234-7186

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041697A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100375850A
IN
Enumeration date
11/07/2006
Last updated
07/08/2007
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