Healthcare Provider Details

I. General information

NPI: 1265641518
Provider Name (Legal Business Name): SARIKA SHAROD GUNDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 CHEMIN METAIRIE ROAD SUITE A
YOUNGSVILLE LA
70592-5382
US

IV. Provider business mailing address

917 W GLORIA SWITCH RD SUITE A
LAFAYETTE LA
70507-2309
US

V. Phone/Fax

Practice location:
  • Phone: 337-856-6880
  • Fax: 337-856-6838
Mailing address:
  • Phone: 337-886-6455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.203176
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: