Healthcare Provider Details

I. General information

NPI: 1063041911
Provider Name (Legal Business Name): NAVYA VADLAMUDI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

452 W 10TH AVE
COLUMBUS OH
43210-1240
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS022776
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number34.017515
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: