Susmitha Anumukonda, MBBH
Pediatrics in Shreveport, LA. Individual provider (NPI-1).
NPI number1184826968
StatusActive
Last updated in NPPESJul 6, 2021
Details
- NPI
- 1184826968
- Entity type
- Individual (NPI-1)
- Name
- Susmitha Anumukonda
- Credential
- MBBH
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 4, 2007
- Certification date
- Jul 6, 2021
- Last updated
- Jul 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | MD202111 | LA | Yes |
| 2080P0204X | Pediatrics, Pediatric Emergency Medicine | 202111 | LA |
Practice location
2518 Bert Kouns Industrial LoopShreveport, LA 71118-3112
Phone 318-212-5437 · Fax 318-212-5825
Mailing address
2518 Bert Kouns Industrial LoopShreveport, LA 71118-3112
Phone 318-212-5437 · Fax 318-212-5825
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