Individual
SUDIPTA ROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6673
Mailing address
2390 W CONGRESS ST, LSU DEPT OF FAMILY PRACTICE, LAFAYETTE, LA 70506-4205
(337) 261-6673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GETP.200133
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006971
—
LA
Enumeration date
08/10/2007
Last updated
04/17/2013
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