Basic Information
| Provider Information | |||||||||
| NPI: | 1811372733 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TAMMINEEDI | ||||||||
| FirstName: | DEVI | ||||||||
| MiddleName: | SAMEERA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4755 OGLETOWN STANTON RD | ||||||||
| Address2: | STE 5A43 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197182200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026230188 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1701 W CHARLESTON BLVD | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891022325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026712358 | ||||||||
| FaxNumber: | 7026712376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2015 | ||||||||
| LastUpdateDate: | 04/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C1-00127 | DE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.