Provider Demographics
NPI:1255476107
Name:MUNIREDDY, SANJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:MUNIREDDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 FALLSTAFF MANOR CT APT D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2823
Mailing Address - Country:US
Mailing Address - Phone:813-390-2931
Mailing Address - Fax:
Practice Address - Street 1:425 W 3RD AVE, STE. 410
Practice Address - Street 2:PHOEBE SURGICAL ONCOLOGY
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1954
Practice Address - Country:US
Practice Address - Phone:229-312-0707
Practice Address - Fax:229-312-0705
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0703182086X0206X
MDP20960208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery