Provider Demographics
NPI:1023275617
Name:SINGANAMALA, SWATHI (MD)
Entity type:Individual
Prefix:DR
First Name:SWATHI
Middle Name:
Last Name:SINGANAMALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SWATHI
Other - Middle Name:
Other - Last Name:SINGANAMALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:640 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3297
Mailing Address - Country:US
Mailing Address - Phone:478-745-5455
Mailing Address - Fax:478-803-5232
Practice Address - Street 1:640 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3297
Practice Address - Country:US
Practice Address - Phone:478-745-5455
Practice Address - Fax:478-803-5232
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071607207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201110030Medicaid
IN164210002Medicare PIN