Individual
LAKSHMI GULLAPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 533-2141
Mailing address
PO BOX 753, GOSHEN, IN 46527-0753
(937) 323-5400
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01048356A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363639
BC BS
IN
Enumeration date
07/15/2005
Last updated
07/08/2007
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