SIREESHA DATLA (NPI# 1275819526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275819526 |
| Entity Type | Individual |
| Full Name | SIREESHA DATLA |
| Other Name | SIREESHA DATLA |
| Credential | MD |
| Practice Address |
13188 N 103rd Dr Ste 201 Sun City AZ 85351-3066 |
| Practice Telephone | 8044095514 |
| Mailing Telephone | 8044095514 |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 263027 | NY | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
57785 | AZ | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 263027 | NY | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 450 Clarkson Ave # 1262, Brooklyn, NY 112032012 | 9172911875 |
| Street Address |
13188 N 103RD DR STE 201 |
| City | SUN CITY |
| State | AZ |
| Zip Code | 85351-3066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003566 | T&h Hearing LLC | Hearing Aid Equipment | 13616 N. 99th Ave., Sun City, AZ 85351 | 2019-09-20 |
| 1881247682 | Amanda M Neri | Physician Assistant | 10401 W. Thunderbird Blvd Md Anderson - Banner Boswell, Sun City, AZ 85351 | 2019-07-20 |
| 1649822313 | Azmed Rehab LLC | Family Medicine | 14281 North Del Webb Blvd, Sun City, AZ 85351 | 2019-07-12 |
| 1982182267 | Akdhc, LLC | Internal Medicine | 10249 W Thunderbird Blvd Ste 100, Sun City, AZ 85351 | 2018-07-30 |
| 1871084814 | Amy Mikulec | Physical Therapist | Banner Physical Therapy and Rehab Boswell, 10503 W Thunderbird Blvd Suite 263a, Sun City, AZ 85351 | 2018-05-25 |
| 1194238345 | Lorie Jo Matthews | Nurse Practitioner | 10494 W Thunderbird Blvd Ste 102, Sun City, AZ 85351 | 2017-11-09 |
| 1184153363 | Susan Jane Hockman | Registered Nurse | 14601 N Delwebb Blvd, Sun City, AZ 85351 | 2017-06-09 |
| 1043769169 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 13203 N 103rd Ave Ste J1&j2, Sun City, AZ 85351 | 2016-09-30 |
| 1033563002 | Vittoria Giovannucci | Technician/Technologist | 10503 W Thunderbird Blvd Ste 101a, Sun City, AZ 85351 | 2016-04-15 |
| 1669858379 | Qui Nguyen | Pharmacist | 10660 Nw Grand Ave, Sun City, AZ 85351 | 2015-08-04 |
| Find all providers in zip 85351 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831454149 | Mohammed Salhab | Internal Medicine | Banner Boswell Medical Center, 10401 W. Thunderbird Blvd, Sun City, AZ 85351-3004 | 2012-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740700798 | Iloabueke Gabriel Chineke | Internal Medicine | 3838 N. Campbell Ave, Tucson, AZ 85719-1454 | 2017-06-21 |
| 1699035717 | Robert Dukjun Yoo | Internal Medicine | 1432 S Dobson Rd Ste 106, Mesa, AZ 85202 | 2012-05-22 |
| 1548538499 | Robert David Ligorsky | Internal Medicine | 11035 E Acoma Dr, Scottsdale, AZ 85255-1865 | 2011-12-07 |
| 1972895340 | Abhishek Harshad Patel | Internal Medicine | 5750 W Thunderbird Rd Ste C300, Glendale, AZ 85306-4666 | 2011-05-04 |
| 1487989927 | Clevius Arnold Curry | Internal Medicine | 10500 E Lost Canyon Dr Lot 8, Scottsdale, AZ 85255-4454 | 2009-10-15 |
| 1972746287 | Keerti Khandelwal | Internal Medicine | 1951 W 25th St Ste F, Yuma, AZ 85364-6924 | 2009-04-16 |
| 1336384809 | Irwin W Tischler | Internal Medicine | 4638 E Berneil Dr, Phoenix, AZ 85028-5500 | 2008-12-11 |
| 1205086378 | Desert Springs Cancer Care, P.l.c. | Internal Medicine | 8950 S 52nd St, Suite 101, Tempe, AZ 85284-1046 | 2008-09-25 |
| 1114182185 | Maria Mercedes Brenneisen | Internal Medicine | 21600 W El Grande Trl, Wickenburg, AZ 85390-3476 | 2008-07-18 |
| 1568625077 | Lida A Mina | Internal Medicine | 2940 E. Banner Gateway Dr., Gilbert, AZ 85234 | 2008-07-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.