Individual
SUSMITHA ANUMUKONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBH
Contact information
Practice address
2518 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3112
(318) 212-5437
(318) 212-5825
Mailing address
2518 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3112
(318) 212-5437
(318) 212-5825
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD202111
LA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
202111
LA
Other
Enumeration date
06/04/2007
Last updated
07/06/2021
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