Individual
SWARNA GADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 724-6125
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2021-1017
NM
207RN0300X
Nephrology Physician
2016007743
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/21/2011
Last updated
02/10/2022
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