Healthcare Provider Details

I. General information

NPI: 1275151748
Provider Name (Legal Business Name): SAHITH THOTAMGARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 10TH ST SE STE 225
CEDAR RAPIDS IA
52403-2419
US

IV. Provider business mailing address

202 10TH ST SE STE 225
CEDAR RAPIDS IA
52403-2419
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-7101
  • Fax:
Mailing address:
  • Phone: 319-364-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD-56030
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: