Individual
DR. SRIDHAR REDDY TIRUMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF ANESTHESIOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
P.O. BOX 5310, DEPARTMENT OF ANESTHESIOLOGY, SHREVEPORT, LA 71135-5310
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD.205973
LA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD.205973
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2342169
—
LA
01
—
295560YH54
MEDICARE - PTAN
LA
01
—
295560YJQN
MEDICARE - PTAN
LA
Enumeration date
02/02/2011
Last updated
05/07/2014
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