Provider Demographics
NPI:1689447997
Name:MALLAMPATI, SARADHI
Entity Type:Individual
Prefix:DR
First Name:SARADHI
Middle Name:
Last Name:MALLAMPATI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 N ARCADIAN CIR APT 302
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-5998
Mailing Address - Country:US
Mailing Address - Phone:713-791-9113
Mailing Address - Fax:
Practice Address - Street 1:37 N ARCADIAN CIR APT 302
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-5998
Practice Address - Country:US
Practice Address - Phone:713-791-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26168247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician