Provider Demographics
NPI:1316266927
Name:TS REDDY MD PC
Entity type:Organization
Organization Name:TS REDDY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SIVAREDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEGULAPALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-968-2200
Mailing Address - Street 1:601 S SHORE DR
Mailing Address - Street 2:SUITE 327
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5440
Mailing Address - Country:US
Mailing Address - Phone:269-968-2200
Mailing Address - Fax:269-968-3787
Practice Address - Street 1:601 S SHORE DR
Practice Address - Street 2:SUITE 327
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5440
Practice Address - Country:US
Practice Address - Phone:269-968-2200
Practice Address - Fax:269-968-3787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIST045341207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1245302660Medicare Oscar/Certification