MEDICARE: DR. SATHYA PADMAJA VEMURI 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
1	207Q00000X	Family Medicine Physician	30657	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1962507376	OTHER	CLINIC NPI
2	1043324932	OTHER	CLINIC NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1063433720	OTHER	CLINIC NPI
5	1245344316	OTHER	CLINIC NPI

General Provider Information

NPI Number	:	1407889017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SATHYA PADMAJA VEMURI M.D.

Provider Business Mailing Address
First Line	:	10230 W HAPPY VALLEY PKWY
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-4691
Country	:	US
Telephone Number	:	623-561-3030
Fax Number	:	623-825-5630

Provider Business Practice Location Address
First Line	:	10230 W HAPPY VALLEY PKWY
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-4691
Country	:	US
Telephone Number	:	623-561-3030
Fax Number	:	623-825-5630

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	01/05/2026

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