Individual
DR. RICARDO ANDAYA MADDELA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
03288
KY
208600000X
Surgery Physician
Primary
34.016302
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000700445
ANTHEM
KY
05
—
7100152020
—
KY
Enumeration date
06/27/2008
Last updated
05/10/2023
Update your record
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