| Doctor Name: | DR. SHILPA GOPAL REDDY |
| NPI Number: | 1639218639 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 2006-0363 |
| Business Practice Address: | 5310 Homestead Rd Ne Suite 301 Albuquerque, NM - 871101437 |
| Business Phone Number: | 5058724700 |
| Business Fax Number: | 5058724709 |
| Mailing Address: | 5310 Homestead Rd Ne, Suite 301 ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871101437 |
| Phone Number: | 5058724700 |
| Fax Number: | 5058724709 |
| NPI Enumeration Date: | 02/06/2007 |
| NPI Last Update Date: | 01/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2006-0363 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |