Provider Demographics
NPI:1154635753
Name:PALADUGU, SAMATHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMATHA
Middle Name:
Last Name:PALADUGU
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 1:3555 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE1080
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3912
Mailing Address - Country:US
Mailing Address - Phone:614-268-8164
Mailing Address - Fax:614-268-8406
Practice Address - Street 1:3555 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 1080
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3912
Practice Address - Country:US
Practice Address - Phone:614-268-8164
Practice Address - Fax:614-268-8406
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35120732207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087084Medicaid
OHH240450Medicare PIN