Individual
DR. SIRISH MADDALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
244 WESTERN AVENUE, SOUTH PORTLAND, ME 04106
(207) 775-3446
(207) 879-1646
Mailing address
244 WESTERN AVENUE, SOUTH PORTLAND, ME 04106
(207) 775-3446
(207) 879-1646
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A90979
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30209881
—
NH
Enumeration date
02/08/2007
Last updated
01/13/2011
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