Individual
DR. ANUSTUP DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 PICONE RD, APARTMENT 2D, HOUMA, LA 70363-3204
(985) 688-0240
Mailing address
110 PICONE RD, APARTMENT 2D, HOUMA, LA 70363-3204
(985) 688-0240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-38827
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2011
Last updated
06/07/2017
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