Provider Demographics
NPI:1932307691
Name:KADARIA, DIPEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DIPEN
Middle Name:
Last Name:KADARIA
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 1000
Mailing Address - Street 2:DEPT # 457
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-758-7888
Mailing Address - Fax:901-387-5153
Practice Address - Street 1:1325 EASTMORELAND AVE
Practice Address - Street 2:SUITE 370
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3519
Practice Address - Country:US
Practice Address - Phone:901-758-7888
Practice Address - Fax:901-387-5153
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49612207RC0200X, 207RP1001X
CODR.0058033207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01289042OtherRAILROAD MEDICARE
AR198151001Medicaid
TN4355725OtherBCBS
CO029310OtherKAISER COMMERCIAL NUMBER
TNQ002087Medicaid