Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | P20960 | MD |
N | 208600000X | Surgeon | P20960 | MD |
Y | 2086X0206X | Surgical Oncologist | 070318 | GA |
NPI | 1255476107 |
---|---|
Provider Name | Dr. Sanjay Munireddy |
First Address | Baltimore, MD 21209-2823 |
Second Address | Albany, GA 31701-1954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 17/03/2018 |