Provider Demographics
NPI:1417044082
Name:SINNATHAMBY, KUDDYTHAMBY (MD)
Entity Type:Individual
Prefix:MR
First Name:KUDDYTHAMBY
Middle Name:
Last Name:SINNATHAMBY
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 1:5538 PHILADELPHIA DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415
Mailing Address - Country:US
Mailing Address - Phone:937-278-3625
Mailing Address - Fax:937-278-3431
Practice Address - Street 1:5538 PHILADELPHIA DRIVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415
Practice Address - Country:US
Practice Address - Phone:937-278-3625
Practice Address - Fax:937-278-3431
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35032806207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0149459Medicaid
SI0350854Medicare ID - Type Unspecified
OH0149459Medicaid