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General NPI Number Information
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NPI Number | 1134225493
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Entity Type | Individual
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Provider Name | MADHAVI GARIMELLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 3917 WEST RD SUITE A
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City | LOS ALAMOS
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State | NM
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Zip | 87544-2275
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Country | US
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Telephone | 505-661-8900
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Fax | 505-661-8961
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Provider Business Mailing Address
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Address Line | 3917 WEST RD SUITE A
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City | LOS ALAMOS
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State | NM
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Zip | 87544-2275
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Country | US
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Telephone | 505-661-8900
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Fax | 505-661-8961
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD2006-0613
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License Number State | NM
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