Individual
DR. YAMUNA GANGADHARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3911 AVENUE B, STE 1100, SCOTTSBLUFF, NE 69361-4617
(308) 630-2101
Mailing address
3911 AVENUE B, STE 1100, SCOTTSBLUFF, NE 69361-4617
(308) 630-2101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25677
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025668100
—
NE
Enumeration date
06/23/2006
Last updated
07/12/2010
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