Provider Demographics
NPI:1881901916
Name:MACHIREDDY, SEENAMMA (MD)
Entity type:Individual
Prefix:
First Name:SEENAMMA
Middle Name:
Last Name:MACHIREDDY
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 1:1100 BOARDMAN CANFIELD RD
Mailing Address - Street 2:APT 54B
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-8056
Mailing Address - Country:US
Mailing Address - Phone:785-320-0985
Mailing Address - Fax:
Practice Address - Street 1:1053 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1007
Practice Address - Country:US
Practice Address - Phone:330-744-2149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHACKNOWLEDGEMENT LETT207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine