Provider Demographics
NPI:1962420695
Name:REDDY, LAKSHMI PATURU (MD)
Entity type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:PATURU
Last Name:REDDY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:10700 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8456
Mailing Address - Country:US
Mailing Address - Phone:678-615-7878
Mailing Address - Fax:770-685-1241
Practice Address - Street 1:10700 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8456
Practice Address - Country:US
Practice Address - Phone:678-615-7878
Practice Address - Fax:770-685-1241
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-10-28
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Provider Licenses
StateLicense IDTaxonomies
MO20040085522080N0001X, 2080P0204X
GA60595207K00000X, 207KA0200X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209005701Medicaid
MO209005701Medicaid