Provider Demographics
NPI:1053388363
Name:KATTA, HARITHA REDDY (MD)
Entity type:Individual
Prefix:
First Name:HARITHA
Middle Name:REDDY
Last Name:KATTA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:651-254-3456
Mailing Address - Fax:651-254-9673
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:MC 11109E
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-3456
Practice Address - Fax:651-254-9673
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2014-01-23
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Provider Licenses
StateLicense IDTaxonomies
MN44559207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN088882600Medicaid
H70492Medicare UPIN
MN088882600Medicaid