Provider Demographics
NPI:1336588425
Name:PADDA, AMRITA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMRITA
Middle Name:
Last Name:PADDA
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 1:5700 MONROE ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2735
Mailing Address - Country:US
Mailing Address - Phone:567-585-0111
Mailing Address - Fax:
Practice Address - Street 1:5700 MONROE ST STE 202
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2735
Practice Address - Country:US
Practice Address - Phone:567-585-0115
Practice Address - Fax:567-585-0119
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013020175207R00000X
MI4301109044207R00000X
OH35.133863207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine