Basic Information
| Provider Information | |||||||||
| NPI: | 1881049690 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REDDY | ||||||||
| FirstName: | RESHMA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 260 MACNIDER BUILDING | ||||||||
| Address2: | CB# 7220 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661505 | ||||||||
| FaxNumber: | 9199667299 | ||||||||
| Practice Location | |||||||||
| Address1: | 260 MACNIDER BUILDING | ||||||||
| Address2: | CB# 7220 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661505 | ||||||||
| FaxNumber: | 9199667299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2016 | ||||||||
| LastUpdateDate: | 05/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 82317 | SC | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 218232 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.