MEDICARE: DR. SILPA BHARATHI GADIRAJU 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
1	207P00000X	Emergency Medicine Physician	19580	MS

General Provider Information

NPI Number	:	1568652238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SILPA BHARATHI GADIRAJU M.D.

Provider Business Mailing Address
First Line	:	6440 SOUTH MILLROCK DRIVE
Second Line	:	COMPHEALTH LOCUM TENENS EMERGENCY MEDICINE SUITE 175
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3100
Country	:	US
Telephone Number	:	801-930-3429
Fax Number	:

Provider Business Practice Location Address
First Line	:	6440 SOUTH MILLROCK DRIVE
Second Line	:	SUITE 175
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3100
Country	:	US
Telephone Number	:	801-930-3429
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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