Provider Demographics
NPI:1780810614
Name:VADDADI, PRETHI (MD)
Entity type:Individual
Prefix:MS
First Name:PRETHI
Middle Name:
Last Name:VADDADI
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 1:3265 POINT HILL CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-8890
Mailing Address - Country:US
Mailing Address - Phone:901-573-6638
Mailing Address - Fax:
Practice Address - Street 1:3265 POINT HILL CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-8890
Practice Address - Country:US
Practice Address - Phone:901-573-6638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127432174400000X
MS23795207VF0040X
TN50637207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No174400000XOther Service ProvidersSpecialist