Individual
SOUJANYA THUMMATHATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7299
(508) 941-6299
Mailing address
96 PLYMOUTH DR APT 2A, NORWOOD, MA 02062-5475
(224) 610-6201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
281794
MA
207R00000X
Internal Medicine Physician
46774
AL
208M00000X
Hospitalist Physician
Primary
46774
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2016
Last updated
09/28/2023
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