Provider Demographics
NPI:1235420571
Name:LADDHA, SIPRA RATHI (MD)
Entity Type:Individual
Prefix:
First Name:SIPRA
Middle Name:RATHI
Last Name:LADDHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SIPRA
Other - Middle Name:
Other - Last Name:RATHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 RIDGEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-727-5157
Mailing Address - Fax:404-727-4746
Practice Address - Street 1:2004 RIDGEWOOD DRIVE
Practice Address - Street 2:1
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-727-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0692162084N0400X, 2084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program