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Individual

SHANTI P REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3400 OLENTANGY RIVER RD, COLUMBUS, OH 43202-1523
(614) 754-5500
(614) 457-9519
Mailing address
3400 OLENTANGY RIVER RD, COLUMBUS, OH 43202-1523
(614) 754-5500
(614) 457-9519

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.003755
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0081670
OH
01
H179260
MEDICARE PTAN
OH
Enumeration date
02/28/2013
Last updated
04/18/2024
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