Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 9295A | WY |
N | 207RC0000X | Internist - Cardiovascular Disease | MD440592 | PA |
Y | 207RI0011X | Interventional Cardiology | MD440592 | PA |
NPI | 1114128261 |
---|---|
Provider Name | Dr. Anuradha Tunuguntla |
First Address | Shavertown, PA 18708-9328 |
Second Address | Lewisburg, PA 17837-9350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 07/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
62511 | (05) | LA |