Individual
SASIKALA SANNAPAREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4012
(508) 559-6699
(508) 583-4649
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4342
(508) 559-1567
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
226752
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J29983
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
05/19/2006
Last updated
06/11/2010
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