Doctor Name: | DR. SUPRIYA RAO DONTHAMSETTY |
NPI Number: | 1922252576 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O |
License Number: | 1303 |
Business Practice Address: | 2005 Knight Lane Bldg. H Navy Medicine Support Command Attn: Medical Staff Services Jacksonville, FL - 322120140 |
Business Phone Number: | 6045427200 |
Business Fax Number: | |
Mailing Address: | 2005 Knight Lane Bldg. H Navy Medicine Support Command, Attn:medical Staff Services JACKSONVILLE |
State: | FL |
Postal Code: | 322120140 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/10/2008 |
NPI Last Update Date: | 02/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 1303 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |