Individual
SHIVAKANTH BURUGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
224 N LEWIS ST, NEW IBERIA, LA 70563-2841
(337) 560-1144
(337) 560-1102
Mailing address
300 W SAINT MARY BLVD, LAFAYETTE, LA 70506-4638
(337) 233-6593
(337) 235-1032
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
321121
LA
207RN0300X
Nephrology Physician
MD37848
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2516825
—
LA
Enumeration date
04/19/2010
Last updated
05/30/2024
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