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General NPI Number Information
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NPI Number | 1700014818
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Entity Type | Individual
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Provider Name | SUMA SANGISETTY MADDOX M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1244 MAGAZINE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70130-4220
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Country | US
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Telephone | 504-249-3805
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Fax | 504-249-3806
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Provider Business Mailing Address
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Address Line | 1244 MAGAZINE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70130-4220
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Country | US
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Telephone | 504-249-3805
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Fax | 504-249-3806
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | MD.206967
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License Number State | LA
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