| P J M Reddy Md | |
|
2828 Highway 31 S Suite 101 Decatur AL 35603-1510 | |
| (256) 309-5627 | |
| (256) 309-5648 |
| Full Name | P J M Reddy Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 2828 Highway 31 S, Decatur, Alabama |
| Authorized Official Name and Position | Punuru J Reddy (OWNER) |
| Authorized Official Contact | 2563095627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| P J M Reddy Md 2828 Highway 31 S Suite 101 Decatur AL 35603-1510 Ph: (256) 309-5627 | P J M Reddy Md 2828 Highway 31 S Suite 101 Decatur AL 35603-1510 Ph: (256) 309-5627 |
| NPI Number | 1134522485 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 03/03/2023 |
| Medicare PECOS PAC ID | 3072838960 |
|---|---|
| Medicare Enrollment ID | O20150218000482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134522485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Punuru J Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760541197 PECOS PAC ID: 2365404258 Enrollment ID: I20080128000451 |
| Provider Name | Derrick A Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760882690 PECOS PAC ID: 3577881994 Enrollment ID: I20150415002109 |
| Provider Name | Stephanie Rayl-moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831696806 PECOS PAC ID: 4385993443 Enrollment ID: I20180822002259 |
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