Provider Demographics
NPI:1699783258
Name:JONNALAGADDA, HEMA (MD)
Entity type:Individual
Prefix:
First Name:HEMA
Middle Name:
Last Name:JONNALAGADDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEMA
Other - Middle Name:
Other - Last Name:ADUNUTHULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:215-444-3411
Mailing Address - Fax:215-444-3411
Practice Address - Street 1:115 PLYMOUTH RD STE 5
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1407
Practice Address - Country:US
Practice Address - Phone:215-444-3411
Practice Address - Fax:877-409-1886
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428851207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101677679Medicaid
PA245699Medicare PIN