Provider Demographics
NPI:1699988949
Name:MALIREDDY, KISHORE K (MBBS)
Entity type:Individual
Prefix:DR
First Name:KISHORE
Middle Name:K
Last Name:MALIREDDY
Suffix:
Gender:M
Credentials:MBBS
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Mailing Address - Street 1:102 MONROE STREET,
Mailing Address - Street 2:SUITE B
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055
Mailing Address - Country:US
Mailing Address - Phone:318-377-4534
Mailing Address - Fax:318-377-4535
Practice Address - Street 1:102 MONROE STREET,
Practice Address - Street 2:SUITE B
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055
Practice Address - Country:US
Practice Address - Phone:318-377-4534
Practice Address - Fax:318-377-4535
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2014-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA206638208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery