Healthcare Provider Details

I. General information

NPI: 1881627552
Provider Name (Legal Business Name): ARUNA GULLAPALLI MD APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 DUVAL DR
MONROE LA
71201-2986
US

IV. Provider business mailing address

2404 DUVAL DR
MONROE LA
71201-2986
US

V. Phone/Fax

Practice location:
  • Phone: 318-329-3933
  • Fax: 318-322-1134
Mailing address:
  • Phone: 318-329-3933
  • Fax: 318-322-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number10988R
License Number StateLA

VIII. Authorized Official

Name: DR. ARUNA GULLAPALLI
Title or Position: OWNER
Credential: MD
Phone: 318-329-3933