Individual
BHANU P WUNNAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
4864 JACKSON ST, DEPARTMENT OF FAMILY MEDICINE, MONROE, LA 71202-6400
(318) 330-7626
(318) 330-7648
Mailing address
4864 JACKSON ST, DEPARTMENT OF FAMILY MEDICINE, MONROE, LA 71202-6400
(318) 330-7661
(318) 330-7648
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201695
LA
Other
Enumeration date
05/23/2007
Last updated
04/30/2008
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