Provider Demographics
NPI:1366535841
Name:PERUMAREDDI, PARVATHI (DO)
Entity type:Individual
Prefix:DR
First Name:PARVATHI
Middle Name:
Last Name:PERUMAREDDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3461 AUSTIN PEAY HWY
Mailing Address - Street 2:C/O ALLAN BROWNING, RN
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-3801
Mailing Address - Country:US
Mailing Address - Phone:901-261-4500
Mailing Address - Fax:
Practice Address - Street 1:3461 AUSTIN PEAY HWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-3801
Practice Address - Country:US
Practice Address - Phone:901-261-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO1382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine