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Contact Information

SIRISH MADDALI, MD
244 WESTERN AVENUE
SOUTH PORTLAND, ME04106
 Phone: 207-775-3446
 Fax: 207-879-1646
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for SIRISH MADDALI · (Male)

NPI # 1790825487
Status Active
Credentials MD
Entity Individual
Enumeration date 02/08/2007
Last updated 01/13/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A90979
  • NH Medicaid 30209881
Hospital affiliation(s)
  • MAINE MEDICAL CENTER - (Acute Care)
    22 BRAMHALL ST
    PORTLAND, ME 04102
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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