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Individual

SREENATH THATI GANGANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242
(319) 356-1851
(319) 384-8818
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-1851
(319) 384-8818

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD-46088
IA
2084E0001X
Epilepsy Physician
Primary
MD-46088
IA
2084N0400X
Neurology Physician
C1-0012146
DE
2084N0400X
Neurology Physician
MD-46088
IA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
MD-46088
IA

Other

Enumeration date
07/05/2012
Last updated
08/02/2024
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