Provider Demographics
NPI:1831937861
Name:MADDURI, SATHVIK
Entity type:Individual
Prefix:
First Name:SATHVIK
Middle Name:
Last Name:MADDURI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14159 NICHOLAS DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-9096
Mailing Address - Country:US
Mailing Address - Phone:317-766-0467
Mailing Address - Fax:
Practice Address - Street 1:14159 NICHOLAS DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46074-9096
Practice Address - Country:US
Practice Address - Phone:317-766-0467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program