Provider Demographics
NPI:1053432856
Name:REDDY, SHALINI ROHINI (MD)
Entity type:Individual
Prefix:
First Name:SHALINI
Middle Name:ROHINI
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHALINI
Other - Middle Name:ROHINI
Other - Last Name:ANNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:400 CAMPUS BLVD STE 210
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6906
Practice Address - Country:US
Practice Address - Phone:540-536-3470
Practice Address - Fax:540-536-3471
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258958208G00000X, 208G00000X
WV29178208600000X
MA232953208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2140471Medicaid
MA000218203Medicare PIN
MA2140471Medicaid
MA000218202Medicare PIN