Individual
MS. ANITHA GADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
635 EAST BASELINE ROAD, PHOENIX, AZ 85042
(602) 243-7277
(602) 243-1235
Mailing address
2702 NORTH 3RD STREET, 4020, PHOENIX, AZ 85004
(602) 323-3344
(602) 323-3496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44481
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
715337
—
AZ
Enumeration date
07/10/2008
Last updated
08/07/2013
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