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Individual

DR. VISHWANATH MUKKAMALLA REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2417 AL HIGHWAY 202, ANNISTON, AL 36201-5349
(256) 237-7990
Mailing address
1400 LEIGHTON AVE, ANNISTON, AL 36207-3827
(256) 237-7990
(256) 237-8881

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24178
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01924
BLUE CROSS BLUE SHIELD AL
AL
01
04-01961
UNITED
AL
01
1980540
FIRST HEALTH
AL
01
49536960049
AMA ME NUMBER
AL
Enumeration date
02/14/2006
Last updated
03/21/2020
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