Reddy, Jagadeesh

Reddy, Jagadeesh is an individual health care provider with primary practice located at 707 N Michigan St Ste 400, South Bend IN 46601-1071. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Reddy, Jagadeesh can be contacted via phone (574) 647-8470.

Contact Information

Primary practice address
707 N Michigan St Ste 400 South Bend IN 46601-1071
Phone: (574) 647-8470
Fax: (574) 647-8475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 01070943A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01070943A Indiana

Profile Details

NPI number 1275705691
LBN Legal business name Reddy, Jagadeesh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2008
Last updated Apr 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275705691 NPPES
Indiana MEDICAID 201163020

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