Provider Demographics
NPI:1609144518
Name:PADAM, SRIPAL ADITYA (MD,)
Entity type:Individual
Prefix:DR
First Name:SRIPAL ADITYA
Middle Name:
Last Name:PADAM
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 W NEWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4309
Mailing Address - Country:US
Mailing Address - Phone:352-333-4000
Mailing Address - Fax:352-333-5157
Practice Address - Street 1:1603 MORGAN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3430
Practice Address - Country:US
Practice Address - Phone:319-524-6274
Practice Address - Fax:319-524-9068
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128117207RG0300X
IL125055831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine