Provider Demographics
NPI:1538696158
Name:REDDY, SUSHMA (MD)
Entity type:Individual
Prefix:MS
First Name:SUSHMA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-3503
Mailing Address - Country:US
Mailing Address - Phone:828-694-7642
Mailing Address - Fax:828-694-7641
Practice Address - Street 1:617 6TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3503
Practice Address - Country:US
Practice Address - Phone:828-694-7642
Practice Address - Fax:828-694-7641
Is Sole Proprietor?:No
Enumeration Date:2017-05-13
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33995207V00000X
IA49449207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology