Provider Demographics
NPI:1174858443
Name:GRANDHE, RADHIKA PRASAD (MBBS, FRCA, MD)
Entity Type:Individual
Prefix:DR
First Name:RADHIKA
Middle Name:PRASAD
Last Name:GRANDHE
Suffix:
Gender:F
Credentials:MBBS, FRCA, MD
Other - Prefix:DR
Other - First Name:RADHIKA
Other - Middle Name:JAGANNATHAIAH
Other - Last Name:KASETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY MSC10 6000
Mailing Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-1113
Mailing Address - Fax:505-272-1300
Practice Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY MSC10 6000
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-1113
Practice Address - Fax:505-272-1300
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0561207L00000X, 208VP0014X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program