Individual
GEETA SANTOSHI TADEPALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
DOGWOOD AVENUE, VA BLDG 52, MOUNTAIN HOME, TN 37684
(423) 439-2225
(423) 439-2250
Mailing address
PO BOX 70567, ETSU DEPARTMENT OF PSYCHIATRY, JOHNSON CITY, TN 37614-1707
(423) 439-2225
(423) 439-2250
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7299620
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2016
Last updated
06/09/2020
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