Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 00027023 | AL |
NPI | 1053361220 |
---|---|
Provider Name | Ramaseetha Gutta |
First Address | Dothan, AL 36301-3012 |
Second Address | Dothan, AL 36301-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |