Provider Demographics
NPI:1467988295
Name:VADDE, NEETHA (MD)
Entity Type:Individual
Prefix:
First Name:NEETHA
Middle Name:
Last Name:VADDE
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 1:2105 E SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2409
Mailing Address - Country:US
Mailing Address - Phone:334-286-3585
Mailing Address - Fax:334-286-3539
Practice Address - Street 1:2105 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2409
Practice Address - Country:US
Practice Address - Phone:334-286-3585
Practice Address - Fax:334-286-3539
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine