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General NPI Number Information
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NPI Number | 1932541406
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Entity Type | Individual
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Provider Name | MADHAVI GADIRAJU MD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 2402 W WALL ST STE 2
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City | MIDLAND
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State | TX
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Zip | 79701-6316
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Country | US
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Telephone | 432-688-7700
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Fax | 432-685-8282
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Provider Business Mailing Address
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Address Line | 4214 ANDREWS HWY STE 240
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City | MIDLAND
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State | TX
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Zip | 79703-4817
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Country | US
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Telephone | 432-686-6605
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Fax | 432-682-2284
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301102304
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R6397
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License Number State | TX
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