Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 25MA08134800 | NJ |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 48461 | CT |
NPI | 1346334141 |
---|---|
Provider Name | Padmalatha Gurram |
First Address | Hartford, CT 06105-1208 |
Second Address | Hartford, CT 06105-1208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 03/09/2015 |