SHIVA JASHWANTH GADDAM

SHREVEPORT, LA
NPI1154983385
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
(Licence: LA  330826)
Additional Taxonomies207R00000X Internal Medicine
(Licence: LA  330826)
Enumeration Date2019-07-09
Last Update Date2025-07-22
Business Address
SHIVA JASHWANTH GADDAM
1541 KINGS HWY
SHREVEPORT, LA 71103-4228
Phone number: 318-626-0000
Mailing Address
SHIVA JASHWANTH GADDAM
1541 KINGS HWY ATTN: PAYOR CREDENTIALING
SHREVEPORT, LA 71103-4228
Phone number: