Individual
PUSHPA LATHA KOYYALAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 N CENTRAL AVE STE 1600, SUITE 1600, PHOENIX, AZ 85004-4633
(602) 262-8917
Mailing address
1850 N CENTRAL AVE STE 1600, SUITE 1600, PHOENIX, AZ 85004-4633
(602) 262-8917
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
52085
AZ
207L00000X
Anesthesiology Physician
ME96567
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279169200
—
FL
Enumeration date
06/12/2007
Last updated
02/01/2017
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