MEDICARE: DR. NIRMALA INDURU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	09686R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124157417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIRMALA INDURU MD

Provider Business Mailing Address
First Line	:	5001 WESTBANK EXPRESSWAY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70072
Country	:	US
Telephone Number	:	504-348-8708
Fax Number	:

Provider Business Practice Location Address
First Line	:	5001 WESTBANK EXPY
Second Line	:
City	:	MARRERO
State	:	LA
Zip	:	70072-2954
Country	:	US
Telephone Number	:	504-349-8708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	06/23/2011

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