Provider Demographics
NPI:1891984910
Name:KOMMAREDDI, SANTI (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTI
Middle Name:
Last Name:KOMMAREDDI
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 1:90 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2523
Mailing Address - Country:US
Mailing Address - Phone:740-779-1053
Mailing Address - Fax:740-773-0093
Practice Address - Street 1:75 HOSPITAL DR
Practice Address - Street 2:STE 370
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2857
Practice Address - Country:US
Practice Address - Phone:740-566-4530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-044632207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology