Provider Demographics
NPI:1689378770
Name:JAMMALAMADAKA, SOUJANYA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SOUJANYA
Middle Name:
Last Name:JAMMALAMADAKA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2597
Mailing Address - Country:US
Mailing Address - Phone:215-345-2200
Mailing Address - Fax:
Practice Address - Street 1:847 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2906
Practice Address - Country:US
Practice Address - Phone:215-345-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT229351390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program