Individual
DR. SUDHA G PILLARISETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Mailing address
1990 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
07882R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1069922
CIGNA
LA
01
—
11-00106
UNITED HEALTHCARE
LA
05
—
1100188
—
LA
05
—
1441996
—
LA
01
—
220022360
PALMETTO GBA - RRMC
LA
01
—
721134010
TRICARE
LA
01
—
721134010A
HUMANA
LA
Enumeration date
11/08/2005
Last updated
09/08/2014
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