Provider Demographics
NPI:1285652115
Name:GADDAM, SWAPAN R (MD)
Entity Type:Individual
Prefix:
First Name:SWAPAN
Middle Name:R
Last Name:GADDAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1364 CLIFTON RD NE
Mailing Address - Street 2:EMORY UNIVERISTY HOSPITAL - HOSPITAL MEDICINE DEPT
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1059
Mailing Address - Country:US
Mailing Address - Phone:404-778-5334
Mailing Address - Fax:404-778-5334
Practice Address - Street 1:1364 CLIFTON RD NE
Practice Address - Street 2:EMORY UNIVERISTY HOSPITAL - HOSPITAL MEDICINE DEPT
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1059
Practice Address - Country:US
Practice Address - Phone:404-778-5334
Practice Address - Fax:404-778-5334
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA055518207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAI22848Medicare UPIN