Provider Demographics
NPI:1366536229
Name:NADIGA, DEEPA NARAYAN (MD)
Entity type:Individual
Prefix:
First Name:DEEPA
Middle Name:NARAYAN
Last Name:NADIGA
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 1:127 EASTGATE DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-3300
Mailing Address - Country:US
Mailing Address - Phone:505-507-9168
Mailing Address - Fax:
Practice Address - Street 1:127 EASTGATE DR
Practice Address - Street 2:SUITE 206
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-3300
Practice Address - Country:US
Practice Address - Phone:505-507-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2000-792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry