Individual
SUJEETH REDDY PUNNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 E MARCH LN, #A-170, STOCKTON, CA 95210-6629
(209) 951-9884
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301087068
MI
207RC0000X
Cardiovascular Disease Physician
Primary
C54250
CA
Other
Enumeration date
10/03/2006
Last updated
01/31/2014
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