Individual
SITAMAHALAKSHMI NUTAKKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1025 W 24TH ST, 25, YUMA, AZ 85364-8366
(928) 344-3411
(924) 344-4194
Mailing address
1025 W 24TH ST, 25, YUMA, AZ 85364-8366
(928) 344-3411
(924) 344-4194
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
14229
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230863
—
AZ
Enumeration date
11/14/2006
Last updated
07/08/2007
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