Provider Demographics
NPI:1134540354
Name:DAVDA, GARGI (MD)
Entity type:Individual
Prefix:
First Name:GARGI
Middle Name:
Last Name:DAVDA
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 1:9011 N MERIDIAN ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5378
Mailing Address - Country:US
Mailing Address - Phone:317-564-2134
Mailing Address - Fax:317-574-4737
Practice Address - Street 1:960 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-2317
Practice Address - Country:US
Practice Address - Phone:765-962-4735
Practice Address - Fax:765-939-0035
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01076264A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201373500Medicaid
IN201373500Medicaid