Individual
REDDY S REGANTI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1225 S GEAR AVE, SUITE 152, WEST BURLINGTON, IA 52655-1691
(319) 753-1220
(319) 753-5464
Mailing address
1225 S GEAR AVE, SUITE 152, WEST BURLINGTON, IA 52655-1691
(319) 753-1220
(319) 753-5464
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
22977
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23382
GRO-BCBS OF IA PROV NUMB
IA
05
—
3213017
—
IA
01
—
32196
CCA-BCBS OF IA PROV NUMB
IA
05
—
4213017
—
IA
Enumeration date
09/13/2005
Last updated
07/09/2007
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