Provider Demographics
NPI:1811372733
Name:TAMMINEEDI, DEVI SAMEERA
Entity Type:Individual
Prefix:
First Name:DEVI
Middle Name:SAMEERA
Last Name:TAMMINEEDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 OGLETOWN STANTON RD
Mailing Address - Street 2:STE 5A43
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-2200
Mailing Address - Country:US
Mailing Address - Phone:302-623-0188
Mailing Address - Fax:
Practice Address - Street 1:1701 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2325
Practice Address - Country:US
Practice Address - Phone:702-671-2358
Practice Address - Fax:702-671-2376
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine