Individual
PUNITHA IDA RATHNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 W NEW HOPE RD, APT A6, GOLDSBORO, NC 27534-7560
(252) 686-8091
(252) 686-8092
Mailing address
400 GLENWOOD AVE, SUITE 8, KINSTON, NC 28501-3870
(252) 686-8091
(252) 686-8092
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2010-01045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160KF
BCBSNC
NC
05
—
5914830
—
NC
Enumeration date
06/11/2007
Last updated
11/16/2014
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