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NPI Code Detail

MEDICARE: DR. SAI KISHORE NANDAMURU M.D.

MEDICARE: DR. SAI KISHORE NANDAMURU 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
12084P0800XPsychiatry Physician041910GA

General Provider Information

NPI Number : 1710983341
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAI KISHORE NANDAMURU M.D.
Provider Business Mailing Address
First Line : 105 WAILEA CT
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-8059
Country : US
Telephone Number : 706-568-6988
Fax Number :
Provider Business Practice Location Address
First Line : 3000 SCHATULGA RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31907-3117
Country : US
Telephone Number : 706-568-6988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 01/17/2014

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