Individual
DR. SANTHARAM V NALLAMSHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1389 S US 301, SUMTERVILLE, FL 33585-5143
(352) 793-5900
(352) 793-9558
Mailing address
1425 S US 301, SUMTERVILLE, FL 33585-5141
(352) 793-5900
(352) 793-8050
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME 82800
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17225
BCBS
FL
05
—
2621185
—
FL
Enumeration date
08/09/2005
Last updated
08/11/2015
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