Individual
KUCHIKULA RAJENDER REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, PCAM 4 SOUTH, PHILADELPHIA, PA 19104-5127
(215) 349-8222
Mailing address
3400 CIVIC CENTER BLVD, PCAM 4 SOUTH, PHILADELPHIA, PA 19104-5127
(215) 349-8222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD073656L
PA
207RG0100X
Gastroenterology Physician
Primary
MD073656L
PA
207RT0003X
Transplant Hepatology Physician
MD073656L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018711540001
—
PA
Enumeration date
02/14/2007
Last updated
10/04/2019
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