Provider Demographics
NPI:1720344666
Name:KATAMREDDY, SASIKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SASIKUMAR
Middle Name:
Last Name:KATAMREDDY
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 1:1503 LAPLACE POINT CT APT 208
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9718
Mailing Address - Country:US
Mailing Address - Phone:914-414-2575
Mailing Address - Fax:
Practice Address - Street 1:1503 LAPLACE POINT CT APT 208
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-9718
Practice Address - Country:US
Practice Address - Phone:914-414-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD452330390200000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program