Provider Demographics
NPI:1477505113
Name:THIMMAPPA, SANDYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDYA
Middle Name:
Last Name:THIMMAPPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDYA
Other - Middle Name:
Other - Last Name:THIMMAPPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1317 N ELM ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1033
Mailing Address - Country:US
Mailing Address - Phone:336-378-1442
Mailing Address - Fax:336-378-1970
Practice Address - Street 1:1317 N ELM ST
Practice Address - Street 2:SUITE 4
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-378-1442
Practice Address - Fax:336-378-1970
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC132F9OtherBLUE CROSS BLUE SHIELD
NC2135314OtherUNITED HEALTHCARE OF NC
NC89132F9Medicaid
NC25448OtherOPTICARE
NCP00368240Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NC2135314OtherUNITED HEALTHCARE OF NC
NC89132F9Medicaid