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Individual

MR. SUDHA SAGAR BENNURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2701 20TH AVENUE, NORTHPORT, AL 35476-3832
(205) 333-5900
(205) 333-6090
Mailing address
2701 20TH AVENUE, NORTHPORT, AL 35476-3832
(205) 333-8900
(205) 333-6090

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22564
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009978025
AL
Enumeration date
09/22/2006
Last updated
03/14/2023
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