Provider Demographics
NPI:1235187071
Name:KADIYALA, HIMA BINDU (MD)
Entity Type:Individual
Prefix:DR
First Name:HIMA
Middle Name:BINDU
Last Name:KADIYALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 WOODSTOCK PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4868
Mailing Address - Country:US
Mailing Address - Phone:678-388-5750
Mailing Address - Fax:678-388-5785
Practice Address - Street 1:970 WOODSTOCK PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4868
Practice Address - Country:US
Practice Address - Phone:678-388-5750
Practice Address - Fax:678-388-5785
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07894700207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00356278OtherRAILROAD MEDICARE
NJI34115Medicare UPIN
NJ092260Medicare ID - Type Unspecified