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Individual

SHIVA JASHWANTH GADDAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
330826
LA
207RH0003X
Hematology & Oncology Physician
Primary
330826
LA

Other

Enumeration date
07/09/2019
Last updated
07/22/2025
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