Individual
DR. SUNEETHA MORTHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2233 CLEMSON RD, COLUMBIA, SC 29229-8016
(803) 462-2824
(803) 386-0283
Mailing address
4611 HARD SCRABBLE RD, SUITE 359, COLUMBIA, SC 29229-8584
(803) 462-2824
(803) 386-0283
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
28893
SC
207RR0500X
Rheumatology Physician
Primary
28893
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288931
—
SC
Enumeration date
07/10/2006
Last updated
06/28/2013
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