Provider Demographics
NPI:1619044690
Name:SIDH, SRIPRIYA DOSS (MD)
Entity Type:Individual
Prefix:
First Name:SRIPRIYA
Middle Name:DOSS
Last Name:SIDH
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 1:4040 EMBASSY PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8326
Mailing Address - Country:US
Mailing Address - Phone:330-576-0500
Mailing Address - Fax:330-576-0467
Practice Address - Street 1:4040 EMBASSY PKWY
Practice Address - Street 2:STE 400
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-8326
Practice Address - Country:US
Practice Address - Phone:330-576-0500
Practice Address - Fax:330-576-0467
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088235207R00000X
OH35088235208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2704934Medicaid
OH000000518273OtherANTHEM
OHP00418811OtherRAILROAD MEDICARE
OH7523900OtherAETNA
OH$$$$$$$$$002OtherMEDICAL MUTUAL
OHKO4198051Medicare ID - Type Unspecified
OH2704934Medicaid