Provider Demographics
NPI:1871606673
Name:VASIREDDY, RAMA (M D)
Entity type:Individual
Prefix:
First Name:RAMA
Middle Name:
Last Name:VASIREDDY
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9590 E IRONWOOD SQUARE DR STE 125
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4583
Mailing Address - Country:US
Mailing Address - Phone:480-455-3000
Mailing Address - Fax:866-819-6115
Practice Address - Street 1:6501 E GREENWAY PKWY STE 160
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2069
Practice Address - Country:US
Practice Address - Phone:480-948-9903
Practice Address - Fax:480-998-5887
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ497950Medicaid
AZZ64466Medicare PIN
AZH10678Medicare UPIN