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NPI Code Detail

MEDICARE: MAMATA YANAMADALA M.D.

MEDICARE: MAMATA YANAMADALA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician4301082261NC

General Provider Information

NPI Number : 1164632642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAMATA YANAMADALA M.D.
Provider Business Mailing Address
First Line : 8536 VIRGILS FARM RD
Second Line :
City : APEX
State : NC
Zip : 27523-7141
Country : US
Telephone Number : 919-656-2380
Fax Number :
Provider Business Practice Location Address
First Line : 1201 BROAD ROCK BLVD
Second Line :
City : RICHMOND
State : VA
Zip : 23249-0002
Country : US
Telephone Number : 804-675-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 12/31/2025

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