Individual
DR. ANDY DELWADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
444 CLINCHFIELD STREET, SUITE 201, KINGSPORT, TN 37660-3606
(423) 230-2500
(423) 230-7502
Mailing address
3021 AZALEA DR, INDIAN LAND, SC 29707-5860
(423) 502-8886
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14815
TN
207R00000X
Internal Medicine Physician
14815
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010118069
—
VA
05
—
3006294
—
TN
01
—
P00194762
RAIL ROAD MEDICARE
TN
Enumeration date
08/11/2006
Last updated
01/04/2024
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