Individual
DR. KIRANMAI BANDARU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 LAKES BLVD, BREAUX BRIDGE, LA 70517-3240
(337) 332-3971
(337) 332-3973
Mailing address
401 YOUNGSVILLE HWY, SUITE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
(337) 330-0059
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
003436
NY
208000000X
Pediatrics Physician
Primary
MD.203991
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2125532
—
LA
Enumeration date
09/08/2009
Last updated
09/10/2016
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