Provider Demographics
NPI:1194043307
Name:CUDDAPAH, SANMATI RAO (MD)
Entity Type:Individual
Prefix:
First Name:SANMATI
Middle Name:RAO
Last Name:CUDDAPAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANMATI
Other - Middle Name:DANDINA
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 E PENN SQ FL 9
Mailing Address - Street 2:CHCA METABOLISM
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3377
Mailing Address - Country:US
Mailing Address - Phone:267-425-9234
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHCA METABOLISM
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-3376
Practice Address - Fax:215-590-4297
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455257207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)