Kadiyala, Mamatha

Kadiyala, Mamatha is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Kadiyala, Mamatha can be contacted via phone (508) 334-3271.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Fax: (508) 856-5911
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X U2239 Texas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 97285 Georgia
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 223247 Massachusetts

Profile Details

NPI number 1851382584
LBN Legal business name Kadiyala, Mamatha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Dec 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851382584 NPPES
Massachusetts MEDICAID 110041533A

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