Healthcare Provider Details

I. General information

NPI: 1275947327
Provider Name (Legal Business Name): SUGUNA VEERAMACHINENI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 DRURY LN
LAFAYETTE LA
70508-5702
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 337-470-9004
  • Fax: 337-470-0022
Mailing address:
  • Phone: 337-470-9004
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number305933
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101275292
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: