Individual
NAMRATA SUSARLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
702 E 34TH ST STE 202, JOPLIN, MO 64804-3921
(417) 347-2525
(417) 347-2552
Mailing address
2805 RIDGEVIEW CT, JOPLIN, MO 64801-8229
(484) 343-7229
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2021036900
MO
Other
Enumeration date
05/17/2018
Last updated
04/27/2022
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