Individual
DR. JYOTHI P TADAVARTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
33 STATE AVE, CARLISLE, PA 17013-4432
(717) 243-6033
(717) 243-0776
Mailing address
1790 ELIZA WAY, MECHANICSBURG, PA 17050-1683
(717) 728-2883
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD041087-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019717680001
—
PA
Enumeration date
02/12/2007
Last updated
02/28/2008
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