MEDICARE: SANJAY DODDAMANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	002296	NY
2	207RC0000X	Cardiovascular Disease Physician	S6385	TX

General Provider Information

NPI Number	:	1558451385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJAY DODDAMANI MD

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:	5HFAM, CARDIOLOGY
City	:	DANVILLE
State	:	PA
Zip	:	17822-9800
Country	:	US
Telephone Number	:	570-214-1991
Fax Number	:	570-214-1480

Provider Business Practice Location Address
First Line	:	3906 N WESTMORELAND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75212-1350
Country	:	US
Telephone Number	:	214-638-2196
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	10/28/2024

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Directions to “ SANJAY DODDAMANI MD” Practice Location

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