Provider Demographics
NPI:1083660146
Name:DONTHIREDDI, USHA RANI (MD)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:RANI
Last Name:DONTHIREDDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-4917
Mailing Address - Fax:919-620-4921
Practice Address - Street 1:7200 CREEDMOOR RD
Practice Address - Street 2:SUITE 208
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1710
Practice Address - Country:US
Practice Address - Phone:919-327-1650
Practice Address - Fax:919-327-1667
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02735757Medicaid
NYP00392223Medicare PIN
NY02735757Medicaid
NYRB5618Medicare PIN
NYRB3119Medicare PIN