Polavarapu, Padmaja Pam

Polavarapu, Padmaja Pam is an individual health care provider with primary practice located at 1810 59Th St W , Bradenton FL 34209-4630. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Other Service Providers / Specialist is her primary health care specialty. Polavarapu, Padmaja Pam can be contacted via phone (941) 792-1412.

Contact Information

Primary practice address
1810 59Th St W Bradenton FL 34209-4630
Phone: (941) 792-1412
Fax: (941) 795-0753
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME108341 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 17433 West Virginia

Profile Details

NPI number 1376536862
LBN Legal business name Polavarapu, Padmaja Pam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Mar 13th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376536862 NPPES
West Virginia Other 007822100 MEDICAID
West Virginia MEDICAID 006048641 MEDICAID

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