Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 06662R | LA |
N | 2080P0207X | Pediatric Hematology-Oncologist | 06662R | LA |
NPI | 1063676518 |
---|---|
Provider Name | Dr. Murali Davuluri |
First Address | Houma, LA 70360-5756 |
Second Address | Houma, LA 70360-5756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2008 |
Last Update Date | 01/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1368750 | (05) | LA |
E84760 | (02) | LA |