Provider Demographics
NPI:1215261268
Name:PINNAMANENI, SOWMYA (MD)
Entity type:Individual
Prefix:
First Name:SOWMYA
Middle Name:
Last Name:PINNAMANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 S LOGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:PA
Mailing Address - Zip Code:17009-1825
Mailing Address - Country:US
Mailing Address - Phone:717-248-5431
Mailing Address - Fax:
Practice Address - Street 1:217 S LOGAN BLVD
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:PA
Practice Address - Zip Code:17009-1825
Practice Address - Country:US
Practice Address - Phone:717-248-5431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455112207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease