Individual
SUNANDA KOTAPURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
931 N CANAL BLVD, THIBODAUX, LA 70301-8095
(985) 446-6381
(985) 446-5992
Mailing address
931 N CANAL BLVD, THIBODAUX, LA 70301-8095
(985) 446-6381
(985) 446-5992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
324292
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2017
Last updated
09/09/2020
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