Provider Demographics
NPI:1285823658
Name:VARDHANA, HARSHA GADADHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:HARSHA
Middle Name:GADADHAR
Last Name:VARDHANA
Suffix:
Gender:M
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:PO BOX 440100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0100
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:615-329-0579
Practice Address - Street 1:1032 MCCALLIE AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2836
Practice Address - Country:US
Practice Address - Phone:423-752-5004
Practice Address - Fax:423-414-3834
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41152207RX0202X
VA0101245389207RH0003X
TNMD0000041152207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN41152OtherMEDICAL LICENSE
TN41152OtherMEDICAL LICENSE
TN103I902888Medicare PIN
TN41152OtherMEDICAL LICENSE