Healthcare Provider Details

I. General information

NPI: 1144636895
Provider Name (Legal Business Name): RAMYA GADDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W.GRAND BOULEVARD,HENRY FORD HOSPITAL,
DETROIT MI
48202-2608
US

IV. Provider business mailing address

2799 W.GRAND BOULEVARD,HENRY FORD HOSPITAL
DETROIT MI
48202-2608
US

V. Phone/Fax

Practice location:
  • Phone: 479-304-8928
  • Fax:
Mailing address:
  • Phone: 479-304-8928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number4301104855
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: