Provider Demographics
NPI:1326510132
Name:GADDE, SIRI (MD)
Entity type:Individual
Prefix:DR
First Name:SIRI
Middle Name:
Last Name:GADDE
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 1:6850 N DURANGO DR STE 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4596
Mailing Address - Country:US
Mailing Address - Phone:702-835-9870
Mailing Address - Fax:702-835-9883
Practice Address - Street 1:6850 N DURANGO DR STE 208
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4596
Practice Address - Country:US
Practice Address - Phone:702-835-9870
Practice Address - Fax:702-835-9883
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV22067207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty