Uma D Duggirala, MD
Individual provider Active NPI Family Medicine Physician · Gallup, NM
NPI 1376511485 · NPPES record last updated Dec 18, 2008
Key facts
- NPI
- 1376511485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2005-0738 (NM)
- Practice address
- 516 E. Nizhoni Blvd
Gallup Indian Medical Center
Gallup, NM 87301-1337 - Phone
- (505) 722-1000
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211209001686 | TX | Order and Referring Only - Family Practice |
5698723112 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2005-0738 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WRH Physicians, Inc. | Past | Accepting new patients | |
| Bes of Ohio, LLC, Dba Medgroup | Past | Accepting new patients | |
| Bes of Ohio, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD2005-0738 | NM | Yes |
Addresses
Primary practice location
516 E. Nizhoni Blvd
Gallup Indian Medical Center
Gallup, NM 87301-1337
Mailing address
1712 Linda Dr
Gallup, NM 87301-5622
Phone (505) 863-8058
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13424718 | Medicaid | NM | |
| 895443 | Medicaid | AZ |
Other providers in Gallup, NM
- Susan Maire Draftz
- Vernon Lee Drummond Jr.
- Darrel Dryden
- Mufaro Dube
- Tiffany Dubos
- Xolani Dumani
- Dungarvin New Mexico, LLC
- Susan O. Dunham
- Dixie K. Dunn
- Candace J Duran
All providers in Gallup, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.