Gadiraju, Gautham S

Gadiraju, Gautham S is an individual health care provider with primary practice located at 400 Rosalind Redfern Grover Pkwy , Midland TX 79701-5846. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gadiraju, Gautham S can be contacted via phone (432) 221-1111.

Contact Information

Primary practice address
400 Rosalind Redfern Grover Pkwy Midland TX 79701-5846
Phone: (432) 221-1111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301089687 Michigan

Profile Details

NPI number 1649462987
LBN Legal business name Gadiraju, Gautham S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2007
Last updated Sep 4th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1649462987 NPPES
Indiana Other 000000701603 ANTHEM
Indiana MEDICAID 387144401 ANTHEM
Indiana Other 685085 ANTHEM

Popular Providers