Healthcare Provider Details

I. General information

NPI: 1750297248
Provider Name (Legal Business Name): LALITH ADITYA AKKIREDDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N OAK AVE
MARSHFIELD WI
54449-5702
US

IV. Provider business mailing address

2002 N HUME AVE APT 103
MARSHFIELD WI
54449-1698
US

V. Phone/Fax

Practice location:
  • Phone: 715-207-4183
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number102648-851
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: