| Provider / Organization | NPI | Date Certified |
|---|---|---|
| NIKHILA REDDY EDAVALLY | 1962021048 | 2023-05-06 |
Nikhila Reddy Edavally is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1962021048. Registration indicates Nikhila Reddy Edavally is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Hospitalist (Hospitalist, ) (All Other Specialties & Provider Types, ) (Hospitalist, Allopathic & Osteopathic Physicians) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Allopathic & Osteopathic Physicians, Hospitalist) (Hospitalist, ) (All Other Specialties & Provider Types, ) (Hospitalist, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Nikhila Reddy Edavally MD |
| Practice Office Address | 625 19TH ST S BIRMINGHAM, AL US |
| Practice Office Telephone | 2059349666 |
| Mailing Address | 625 19TH ST S BIRMINGHAM, AL 352331900 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3620 Howell Ferry Rd | Duluth, GA 300963178 | 6783126800 / 6783126982 |
| Code | Practice | License No State |
|---|---|---|
| 208M00000X | Allopathic & Osteopathic Physicians Hospitalist Hospitalist All Other Specialties & Provider Types Hospitalist Allopathic & Osteopathic Physicians | 95253
GA |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 208M00000X PRIMARY | Allopathic & Osteopathic Physicians Hospitalist Hospitalist All Other Specialties & Provider Types Hospitalist Allopathic & Osteopathic Physicians | 00000
GA |