Basic Information
| Provider Information | |||||||||
| NPI: | 1093120289 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YARLAGADDA | ||||||||
| FirstName: | BHARATH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | MSC CARDIOLOGY 1 UNIVERSITY OF NEW MEXICO | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052729223 | ||||||||
| FaxNumber: | 5052724356 | ||||||||
| Practice Location | |||||||||
| Address1: | MSC CARDIOLOGY 1 UNIVERSITY OF NEW MEXICO | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871311000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052729223 | ||||||||
| FaxNumber: | 5052724356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2014 | ||||||||
| LastUpdateDate: | 07/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2014016551 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 94-09132 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | MD2017-0225 | NM | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0000X | MD2017-0225 | NM | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.