Provider Demographics
NPI:1518936343
Name:SUDIREDDY, NEELIMA R (MD)
Entity Type:Individual
Prefix:
First Name:NEELIMA
Middle Name:R
Last Name:SUDIREDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:WOT 12 FLOOR
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-368-5529
Mailing Address - Fax:508-368-5530
Practice Address - Street 1:340 THOMPSON ROAD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570
Practice Address - Country:US
Practice Address - Phone:508-949-6880
Practice Address - Fax:508-949-6742
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA155224207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3186806Medicaid
33819OtherFALLON COMM HEALTH PLAN
9761373OtherMEDICAID PPC
AA1283OtherHARVARD PILGRIM HLTH CARE
J19441OtherBLUE CARE ELECT
J19441OtherBLUE SHIELD INDEMNITY
7314337OtherAETNA US HEALTHCARE
J19441OtherBLUE SHIELD HMO BLUE
A28743OtherMEDICARE B
51185OtherHEALTHY START
0173470OtherCIGNA HEALTH PLAN
3186806OtherMEDICAID WELFARE
0401706OtherEVERCARE
784255OtherMVP HEALTH CARE
9761373OtherMEDICAID PPC
AA1283OtherHARVARD PILGRIM HLTH CARE