| Praful Reddy Md Pc | |
|
14502 W Meeker Blvd Sun City West AZ 85375-5282 | |
| (480) 718-9277 | |
| Not Available |
| Full Name | Praful Reddy Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 14502 W Meeker Blvd, Sun City West, Arizona |
| Authorized Official Name and Position | Praful Anugu Reddy (OWNER) |
| Authorized Official Contact | 6028433811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Praful Reddy Md Pc Po Box 6227 Scottsdale AZ 85261-6227 Ph: (480) 178-9277 | Praful Reddy Md Pc 14502 W Meeker Blvd Sun City West AZ 85375-5282 Ph: (480) 718-9277 |
| NPI Number | 1154858348 |
|---|---|
| Provider Enumeration Date | 05/18/2017 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Medicare PECOS PAC ID | 0345505277 |
|---|---|
| Medicare Enrollment ID | O20180524002159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154858348 | NPI | - | NPPES |
| 167950616 | Other | AZ | PSYCHIATRY & NEUROLOGY |
| 432823 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Praful A Reddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679590616 PECOS PAC ID: 8628098761 Enrollment ID: I20090701000538 |
| Provider Name | Kelly Milton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770882458 PECOS PAC ID: 8729206099 Enrollment ID: I20140828000060 |
| Provider Name | Michaela Ann Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700368685 PECOS PAC ID: 3274935622 Enrollment ID: I20210708001180 |
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