MEDICARE: MRS. SWARNA K BAREDDY 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	207Q00000X	Family Medicine Physician	MD12344	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DD8757	OTHER	TN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710971593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SWARNA K BAREDDY MD

Provider Business Mailing Address
First Line	:	3309 CUMMINGS HWY
Second Line	:	SUITE A
City	:	CHATTANOOGA
State	:	TN
Zip	:	37419-2360
Country	:	US
Telephone Number	:	423-648-4800
Fax Number	:	423-648-4812

Provider Business Practice Location Address
First Line	:	3309 CUMMINGS HWY
Second Line	:	SUITE A
City	:	CHATTANOOGA
State	:	TN
Zip	:	37419-2360
Country	:	US
Telephone Number	:	423-648-4800
Fax Number	:	423-648-4812

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	02/19/2009

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