Provider Demographics
NPI:1407889017
Name:VEMURI, SATHYA PADMAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:SATHYA
Middle Name:PADMAJA
Last Name:VEMURI
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 1:2060 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6123
Mailing Address - Country:US
Mailing Address - Phone:928-819-8999
Mailing Address - Fax:928-539-5579
Practice Address - Street 1:2060 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6123
Practice Address - Country:US
Practice Address - Phone:928-785-3256
Practice Address - Fax:928-785-3258
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962507376OtherCLINIC NPI
1043324932OtherCLINIC NPI
AZ722761Medicaid
1063433720OtherCLINIC NPI
1245344316OtherCLINIC NPI
031805Medicare Oscar/Certification
031822Medicare Oscar/Certification
031823Medicare Oscar/Certification
H74289Medicare UPIN
AZZ21115Medicare PIN
AZZ21113Medicare PIN
AZZ107263Medicare PIN
1245344316OtherCLINIC NPI
1043324932OtherCLINIC NPI
AZ722761Medicaid
031824Medicare Oscar/Certification
AZZ21130Medicare PIN
AZZ21114Medicare PIN
AZZ107264Medicare PIN
AZZ107262Medicare PIN