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Individual
INDIRA GURUBHAGAVATULA
Active
Individual
INDIRA GURUBHAGAVATULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
053054L
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
053054L
PA
207RP1001X
Pulmonary Disease Physician
053054L
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
053054L
PA
Other
Enumeration date
08/14/2006
Last updated
06/13/2012
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