Individual
UMALAKSHMI KANURU THOTAKURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
125 ASHLEYBROOK SQUARE, WINSTON SALEM, NC 27103
(336) 765-6577
(336) 768-2972
Mailing address
125 ASHLEYBROOK SQUARE, WINSTON SALEM, NC 27103
(336) 765-6577
(336) 768-2972
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9300343
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83341
BCBS OF NC
—
05
—
8983341
—
NC
Enumeration date
10/26/2006
Last updated
06/07/2012
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