Individual
ASHWEENA GONUGUNTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
804 SERVICE RD, SUITE A110, EAST LANSING, MI 48824-7015
(517) 353-3003
(517) 353-5514
Mailing address
804 SERVICE RD # A109F, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301087991
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A839370
—
CA
05
—
1134182009
—
MI
05
—
4947612
—
MI
Enumeration date
04/10/2006
Last updated
05/15/2024
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