Provider Demographics
NPI:1710971593
Name:BAREDDY, SWARNA K (MD)
Entity Type:Individual
Prefix:MRS
First Name:SWARNA
Middle Name:K
Last Name:BAREDDY
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 1:3309 CUMMINGS HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37419-2360
Mailing Address - Country:US
Mailing Address - Phone:423-648-4800
Mailing Address - Fax:423-648-4812
Practice Address - Street 1:3309 CUMMINGS HWY
Practice Address - Street 2:SUITE A
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37419-2360
Practice Address - Country:US
Practice Address - Phone:423-648-4800
Practice Address - Fax:423-648-4812
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD12344207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA407880096AMedicaid
TNDD8757OtherRR MEDICARE
TN3197094Medicaid
TN31970902Medicare PIN
TNDD8757OtherRR MEDICARE
GA407880096AMedicaid
TN3197094Medicare PIN