Individual
ANJU POKKARUPARAMBIL SUKUMARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5246
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5246
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
12387
NC
2080P0205X
Pediatric Endocrinology Physician
Primary
23519
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02936811
—
MS
05
—
18212
—
ND
Enumeration date
07/17/2008
Last updated
05/23/2017
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