Individual
SUSHMITA THOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2879 JAMES BLVD, POPLAR BLUFF, MO 63901-3395
(214) 566-8275
Mailing address
205 MACINTOSH LN, POPLAR BLUFF, MO 63901-9116
(214) 566-8275
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2024026869
MO
Other
Enumeration date
05/11/2021
Last updated
10/09/2024
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