Organization
CLARKSBURG CARDIOLOGY CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
S.M. REDDY M.D. (PARTNER)
(304) 933-3830
Entity
Organization
Contact information
Practice address
527 MEDICAL PARK DRIVE, STE 306, BRIDGEPORT, WV 26330-9008
(304) 933-3830
(304) 933-3837
Mailing address
527 MEDICAL PARK DRIVE, STE 306, BRIDGEPORT, WV 26330-9008
(304) 933-3830
(304) 933-3837
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
044134
WV
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000465033
BCBS GROUP
WV
05
—
000465033
—
WV
05
—
0011726000
—
WV
01
—
1327565
UWMA GROUP
WV
Enumeration date
06/03/2006
Last updated
01/31/2014
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