Provider Demographics
NPI:1487660155
Name:YADLAPALLI, SWARNA L (MD)
Entity Type:Individual
Prefix:
First Name:SWARNA
Middle Name:L
Last Name:YADLAPALLI
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 1:1707 CENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-6050
Mailing Address - Country:US
Mailing Address - Phone:701-231-7331
Mailing Address - Fax:701-231-6132
Practice Address - Street 1:1707 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-6050
Practice Address - Country:US
Practice Address - Phone:701-234-7331
Practice Address - Fax:701-234-6132
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND8575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0123112OtherMEDICA #
ND6609389OtherMEDICA #
ND1298804OtherAMERICA'S PPO/ARAZ #
NDHP56452OtherHEALTHPARTNERS #
ND26694OtherNDBS #
ND050H1YAOtherMNBS #
ND427750300Medicaid
NDDA9011044983OtherPREFERRED ONE #
ND050H1YAOtherMNBS #
ND26694OtherNDBS #