Provider Demographics
NPI:1326191594
Name:GADE, SWAMI PRASAD (MD)
Entity type:Individual
Prefix:DR
First Name:SWAMI
Middle Name:PRASAD
Last Name:GADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E ROSSER AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4457
Mailing Address - Country:US
Mailing Address - Phone:701-751-9500
Mailing Address - Fax:
Practice Address - Street 1:701 E ROSSER AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4457
Practice Address - Country:US
Practice Address - Phone:701-751-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-03320207Q00000X
MI4301509949207Q00000X
MN73299207Q00000X
GA94160207Q00000X
CODR.0069934207Q00000X
IN01090947A207Q00000X
CT45064207Q00000X
OH35.147254207Q00000X
NY320281207Q00000X
VA0101277045207Q00000X
WAMD61369999207Q00000X
ND10620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1472502Medicaid