Provider Demographics
NPI:1245562966
Name:KARNAM, MADHAVI
Entity type:Individual
Prefix:DR
First Name:MADHAVI
Middle Name:
Last Name:KARNAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 HIGHSPIRE RD
Mailing Address - Street 2:
Mailing Address - City:ROMANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4796
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5500 SKYLINE DR STE 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1772
Practice Address - Country:US
Practice Address - Phone:302-239-8586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038151122300000X
DEG10001399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist