Provider Demographics
NPI:1871747287
Name:NADENDLA, HARITHA (MD)
Entity type:Individual
Prefix:
First Name:HARITHA
Middle Name:
Last Name:NADENDLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HARITHA
Other - Middle Name:
Other - Last Name:VATTIGUNTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 PARKWAY OFFICE CT
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7430
Mailing Address - Country:US
Mailing Address - Phone:919-342-5383
Mailing Address - Fax:919-342-0434
Practice Address - Street 1:115 PARKWAY OFFICE CT
Practice Address - Street 2:SUITE 104
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7430
Practice Address - Country:US
Practice Address - Phone:919-342-5383
Practice Address - Fax:919-342-0434
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910738Medicaid