Provider Demographics
NPI:1366848657
Name:YANAMADDI, NARASIMHA
Entity Type:Individual
Prefix:
First Name:NARASIMHA
Middle Name:
Last Name:YANAMADDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3342 N CHATHAM RD APT A
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2764
Mailing Address - Country:US
Mailing Address - Phone:732-666-7636
Mailing Address - Fax:
Practice Address - Street 1:10820 RHODE ISLAND AVE STE F
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2570
Practice Address - Country:US
Practice Address - Phone:301-595-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist