MEDICARE: DEEPA NADIGA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	2000-79	NM

General Provider Information

NPI Number	:	1427429273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEEPA NADIGA MD

Provider Business Mailing Address
First Line	:	1475 CENTRAL AVE STE 220
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-4207
Country	:	US
Telephone Number	:	505-661-9923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1475 CENTRAL AVE STE 220
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-4207
Country	:	US
Telephone Number	:	505-661-9923
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	DR. DEEPA NADIGA
Credential	:
Telephone Number	:	505-661-9923

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/19/2015

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