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General NPI Number Information
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NPI Number | 1487457248
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Entity Type | Individual
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Provider Name | SAI DINESH YERRAMALLA
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Gender | Male
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 300 CARSON ST
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City | JONESBORO
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State | AR
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Zip | 72401-3104
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Country | US
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Telephone | 870-910-7799
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Fax | 870-336-2999
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Provider Business Mailing Address
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Address Line | 566 COMMONWEALTH AVE APT 609
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City | BOSTON
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State | MA
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Zip | 02215-2514
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Country | US
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Telephone | 857-707-5617
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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