Organization
MAMIDI CARDIOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SATYANARAYANA MAMIDI MD (OWNER)
(304) 831-2300
Entity
Organization
Contact information
Practice address
20 HOSPITAL DR, LOGAN, WV 25601
(304) 831-2300
(304) 831-2303
Mailing address
20 HOSPITAL DR, LOGAN, WV 25601
(304) 831-2300
(304) 831-2303
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
WV12853
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083504000
—
WV
Enumeration date
07/05/2006
Last updated
08/22/2020
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