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DEEPIKA REDDY RALLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(860) 986-4098
(507) 607-8545
Mailing address
9552 ROCHEL DR, SHREVEPORT, LA 71115-3854
(860) 986-4098
(507) 607-8545

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.206394
LA
207R00000X
Internal Medicine Physician
Primary
MD12345
LA
207RH0000X
Hematology (Internal Medicine) Physician
MD.206394
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/12/2012
Last updated
06/03/2022
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