Healthcare Provider Details

I. General information

NPI: 1184007072
Provider Name (Legal Business Name): SIDDHARTH NIKHIL KRISHNA VANNEMREDDY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2015
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MEADOWMONT VILLAGE CIR STE 202
CHAPEL HILL NC
27517-7518
US

IV. Provider business mailing address

170 MANNING DRIVE CAMPUS BOX 7025 HOUPT OFFICE BUILDING 2ND FLOOR 2200F
CHAPEL HILL NC
27599-7025
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-4401
  • Fax: 984-974-2285
Mailing address:
  • Phone: 919-966-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2018-01968
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2018-01968
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2018-01968
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: