Provider Demographics
NPI:1750350666
Name:MACHINENI, SRIRAM (MD)
Entity type:Individual
Prefix:
First Name:SRIRAM
Middle Name:
Last Name:MACHINENI
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 1:8025 BURNETT WOMACK BUILDING CAMPUS BOX # 7172
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7170
Mailing Address - Country:US
Mailing Address - Phone:919-966-0134
Mailing Address - Fax:919-966-6025
Practice Address - Street 1:300 MEADOWMONT VILLAGE CIR STE 202
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7518
Practice Address - Country:US
Practice Address - Phone:984-974-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00714207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026422603OtherUNIVERA
NY02439783Medicaid
NY000527387003OtherBLUE CROSS WNY
NY0492995OtherIHA
NYH95122Medicare UPIN
NY0492995OtherIHA