Provider Demographics
NPI:1841388410
Name:ARASHINAGUNDI, SIDDESHA (MD)
Entity Type:Individual
Prefix:MR
First Name:SIDDESHA
Middle Name:
Last Name:ARASHINAGUNDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8617
Mailing Address - Fax:
Practice Address - Street 1:1208 AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4084
Practice Address - Country:US
Practice Address - Phone:864-522-6200
Practice Address - Fax:864-522-6205
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19946207R00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT40514Medicaid
SCG27440Medicare UPIN
12461Medicare UPIN
SC1246Medicare PIN