Individual
UJWAL REDDY NERAVETLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 288-3191
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
19435
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00205323
—
MS
05
—
1318710
—
LA
01
—
7861836
AETNA
MS
01
—
P00368678
RAILROAD MEDICARE
MS
Enumeration date
11/01/2006
Last updated
08/23/2016
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