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General NPI Number Information
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NPI Number | 1184007072
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Entity Type | Individual
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Provider Name | SIDDHARTH NIKHIL KRISHNA VANNEMREDDY MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 800 TILGHMAN DR
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City | DUNN
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State | NC
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Zip | 28334-5510
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Country | US
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Telephone | 910-892-7161
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Fax | 910-694-1314
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Provider Business Mailing Address
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Address Line | PO BOX 40908
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City | FAYETTEVILLE
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State | NC
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Zip | 28309-0908
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Country | US
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Telephone | 910-615-6949
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Fax | 910-615-9761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301108489
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2018-01968
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2018-01968
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License Number State | NC
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