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NPI Code Detail

MEDICARE: DR. PREETI WADHWA M.D.

MEDICARE: DR. PREETI WADHWA M.D.
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
1207Q00000XFamily Medicine Physician4301103219MI
2207Q00000XFamily Medicine Physician49305KY

General Provider Information

NPI Number : 1477993525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PREETI WADHWA M.D.
Provider Business Mailing Address
First Line : 1395 NW 167TH ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-5710
Country : US
Telephone Number : 502-775-1211
Fax Number : 502-398-0041
Provider Business Practice Location Address
First Line : 2406 W BROADWAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40211-1008
Country : US
Telephone Number : 502-775-1211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2013
Last Update Date : 03/24/2020

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