Healthcare Provider Details

I. General information

NPI: 1871565036
Provider Name (Legal Business Name): SAILAJA GADDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 10/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 W 3RD AVE
ALBANY GA
31701-1975
US

IV. Provider business mailing address

PO BOX 84009
COLUMBUS GA
31908-4009
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-5800
  • Fax: 229-312-5853
Mailing address:
  • Phone: 229-312-5800
  • Fax: 229-312-5853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number049015
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: