Individual
GOUTHAM GUDAVALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 769-3000
Mailing address
201 4TH ST # 30162, ALEXANDRIA, LA 71301-8421
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
324147
LA
Other
Enumeration date
06/17/2014
Last updated
07/21/2022
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