Provider Demographics
NPI:1124072145
Name:NADELLA, RAMA M (MD)
Entity type:Individual
Prefix:
First Name:RAMA
Middle Name:M
Last Name:NADELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 WHITESPORT DR SW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6454
Mailing Address - Country:US
Mailing Address - Phone:256-519-9181
Mailing Address - Fax:256-519-9141
Practice Address - Street 1:333 WHITESPORT DR SW
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6454
Practice Address - Country:US
Practice Address - Phone:256-519-9181
Practice Address - Fax:256-519-9141
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21198174400000X
ALMD.211982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000077053Medicaid
MS000119315Medicaid
AL510-44759OtherBLUE CROSS PROVIDER #
AL721397168OtherTAX I D
AZ155455Medicaid