Individual
SADEKA TAMANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20279
MS
207R00000X
Internal Medicine Physician
46125
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-06054
MEDICA
MN
05
—
06325569
—
MS
05
—
131014
—
MN
01
—
155L1TA
BCBS
MN
01
—
1907895
ARAZ
MN
05
—
565333
—
IA
01
—
8586
AVERA
MN
05
—
916487100
—
MN
01
—
HP39742
HEALTH PARTNERS
FM
01
—
MH9041035331
PPO
MN
Enumeration date
12/01/2005
Last updated
05/09/2014
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