Individual
SWETHA VUTUKURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD209451
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2019
Last updated
07/25/2022
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