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NPI Code Detail

MEDICARE: DINESH GADDAM M.D

MEDICARE: DINESH GADDAM M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician31021OK
2207R00000XInternal Medicine Physician31021OK
3207R00000XInternal Medicine PhysicianV3859TX

General Provider Information

NPI Number : 1225383391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DINESH GADDAM M.D
Provider Business Mailing Address
First Line : 6600 S YALE AVE STE 1200
Second Line :
City : TULSA
State : OK
Zip : 74136-3361
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6161 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-1902
Country : US
Telephone Number : 918-502-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2012
Last Update Date : 06/03/2026

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