Provider Demographics
NPI:1942596853
Name:POTTI, TOMMY ASHVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:ASHVIN
Last Name:POTTI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:9998 CROSSPOINT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3307
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:7900 POLO CROSSE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-6565
Practice Address - Country:US
Practice Address - Phone:317-806-8285
Practice Address - Fax:317-489-6750
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2021-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010989082085R0202X
IN01083186A2085R0202X
CA1417562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology