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General NPI Number Information
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NPI Number | 1649535519
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Entity Type | Individual
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Provider Name | PRIYA PRIYAMBADA M.D
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Gender | Female
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 3150 N ELM ST
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City | GREENSBORO
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State | NC
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Zip | 27408-3880
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Country | US
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Telephone | 336-716-7811
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Fax | 336-716-9526
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Provider Business Mailing Address
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Address Line | 2101 HIGHWAY 90
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City | GAUTIER
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State | MS
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Zip | 39553-5340
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Country | US
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Telephone | 228-497-7576
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Fax | 501-526-6562
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 30298
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30298
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-9492
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025-02436
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License Number State | NC
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