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Individual
DR. SAMYUKTHA R MADISHETTY I
Active
Individual
DR. SAMYUKTHA R MADISHETTY I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301080548
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108281851
BCN IND
MI
01
—
I46399
HAP
MI
01
—
P00470436
RAILROAD MEDICARE IND PIN
MI
Enumeration date
11/30/2006
Last updated
12/11/2020
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