Individual
SUSHMA R YERRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 882-1515
(573) 884-0070
Mailing address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 882-1515
(573) 884-0070
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2013034794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013034794
MISSOURI STATE TEMP LICENSE NUMBER
MO
Enumeration date
09/26/2013
Last updated
01/15/2015
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