Individual
DR. NIKHIL P REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712
(909) 210-6082
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(909) 210-6082
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M-14303
ID
208M00000X
Hospitalist Physician
Primary
M-14303
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2015
Last updated
07/18/2018
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