Active NPI
Maithry Uddaraju, M.D.
- Family Medicine Physician
- Maumee, OH
National Provider Identifier
1760681720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 57.012941
- Practice address
- 1657 Holland Rd
Maumee, OH 43537-1661 - Phone
- (419) 794-2180
- Fax
- (419) 794-2175
- NPI assigned
- Jul 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 57.012941 | OH | Primary |
Addresses
Primary practice location
1657 Holland Rd
Maumee, OH 43537-1661
Mailing address
1657 Holland Rd
Maumee, OH 43537-1661
Phone (973) 294-5050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.012941 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287705600000",
"number": "1760681720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1657 HOLLAND RD",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371661",
"telephone_number": "973-294-5050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1657 HOLLAND RD",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371661",
"telephone_number": "419-794-2180",
"fax_number": "419-794-2175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDDARAJU",
"first_name": "MAITHRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-11",
"last_updated": "2010-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "57.012941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.