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Shanta A Purushotham MD PA

Internal Medicine, Rheumatology in Brooksville, FL. Organization (NPI-2).

NPI number1790729044
StatusActive
Last updated in NPPESSep 23, 2011

Details

NPI
1790729044
Entity type
Organization (NPI-2)
Legal business name
Shanta A Purushotham MD PA
Organization subpart
No
Enumeration date
Jun 16, 2006
Last updated
Sep 23, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RR0500X Internal Medicine, Rheumatology––Yes

Practice location

711 Harvard St
Brooksville, FL 34601-2842

Phone 352-799-0135 · Fax 352-754-5394

Mailing address

711 Harvard St
Brooksville, FL 34601-2842

Phone 352-799-0135 · Fax 352-754-5394

Authorized official

Shanta A Purushotham
MD
3527990135

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