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Individual

SIRISHA GADDIPATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1305
(937) 522-7513

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.092312
OH
207R00000X
Internal Medicine Physician
37269
AZ
208M00000X
Hospitalist Physician
Primary
092312
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277321
AZ
05
2889950
OH
01
H361502
MEDICARE
OH
Enumeration date
09/04/2007
Last updated
11/25/2024
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