Provider Demographics
NPI:1598981979
Name:REDDYMASU, SAVIO (MD)
Entity type:Individual
Prefix:
First Name:SAVIO
Middle Name:
Last Name:REDDYMASU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 S LINDSAY RD STE 115
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-4334
Mailing Address - Country:US
Mailing Address - Phone:602-541-1575
Mailing Address - Fax:602-926-1418
Practice Address - Street 1:3011 S LINDSAY RD STE 115
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295
Practice Address - Country:US
Practice Address - Phone:602-541-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56312207RG0100X
IA36743207R00000X
KS32032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098684244OtherMEDICARE PTAN