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General NPI Number Information
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NPI Number | 1376748822
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Entity Type | Individual
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Provider Name | SUSHMA NUTHAKKI MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 7400 FANNIN ST STE 810
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City | HOUSTON
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State | TX
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Zip | 77054-1935
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Country | US
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Telephone | 281-833-0999
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Fax | 281-833-9302
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Provider Business Mailing Address
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Address Line | 555 S 18TH ST
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City | COLUMBUS
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State | OH
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Zip | 43205-2654
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Country | US
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Telephone | 614-722-4559
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Fax | 614-722-4541
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 35090368
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | P8288
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License Number State | TX
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