Provider Demographics
NPI:1396748984
Name:REDDY, KARUNA DYAPA (MD)
Entity type:Individual
Prefix:
First Name:KARUNA
Middle Name:DYAPA
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARUNA
Other - Middle Name:DYAPA
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:303A SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-2333
Mailing Address - Country:US
Mailing Address - Phone:912-383-8806
Mailing Address - Fax:912-383-8147
Practice Address - Street 1:303A SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2333
Practice Address - Country:US
Practice Address - Phone:912-383-8806
Practice Address - Fax:912-383-8147
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0295192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10057593OtherAMERIGROUP MEDICAID
260049820OtherRAILROAD MEDICARE
GA000399814HMedicaid
260049820OtherRAILROAD MEDICARE
260049820OtherRAILROAD MEDICARE
E09144Medicare UPIN