Provider Demographics
NPI:1922414440
Name:SINGIREDDY, SAMPATH REDDY (MD)
Entity type:Individual
Prefix:
First Name:SAMPATH
Middle Name:REDDY
Last Name:SINGIREDDY
Suffix:
Gender:M
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:PO BOX 040005
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-4005
Mailing Address - Country:US
Mailing Address - Phone:256-351-0688
Mailing Address - Fax:256-265-1633
Practice Address - Street 1:1107 14TH AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3326
Practice Address - Country:US
Practice Address - Phone:256-351-0688
Practice Address - Fax:256-265-1633
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.42698207RC0000X, 207RC0000X
AL42698207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL271453Medicaid