Provider Demographics
NPI:1669542809
Name:REDD, DAVID C (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:REDD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2205 MCCALLIE AVE
Mailing Address - Street 2:STE 507
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3230
Mailing Address - Country:US
Mailing Address - Phone:423-622-3191
Mailing Address - Fax:423-622-3192
Practice Address - Street 1:2205 MCCALLIE AVE
Practice Address - Street 2:STE 507
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3230
Practice Address - Country:US
Practice Address - Phone:423-622-3191
Practice Address - Fax:423-622-3192
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN0000029429208600000X
GA035505208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
3811546Medicare ID - Type Unspecified
C70958Medicare UPIN