Healthcare Provider Details

I. General information

NPI: 1497252480
Provider Name (Legal Business Name): DR. NEHA GAYATRI GADDAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2018
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9103 FRANKLIN SQUARE DR STE 305
BALTIMORE MD
21237-3939
US

IV. Provider business mailing address

9103 FRANKLIN SQUARE DR STE 305
BALTIMORE MD
21237-3939
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-7608
  • Fax:
Mailing address:
  • Phone: 443-777-7608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberD0104518
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberMD210002227
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: