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Individual

SRIVALLI DONTHINENI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1125 W HIGHWAY 30, GONZALES, LA 70737-5004
(225) 647-8511
(225) 644-5213
Mailing address
1125 W. HWY 30, GONZALES, LA 70737
(225) 647-8511
(225) 644-5213

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15830R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1476951
LA
Enumeration date
08/21/2006
Last updated
09/13/2011
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