Individual
DR. PAVANKUMAR THOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(866) 624-7637
Mailing address
4301 TULANE AVE APT 366, NEW ORLEANS, LA 70119-6761
(940) 704-8096
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
331480
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2019
Last updated
07/10/2022
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