Provider Demographics
NPI:1154303261
Name:GULLAPALLI, ARUNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUNA
Middle Name:
Last Name:GULLAPALLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 DUVAL DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2986
Mailing Address - Country:US
Mailing Address - Phone:318-329-3933
Mailing Address - Fax:318-322-1134
Practice Address - Street 1:2404 DUVAL DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2986
Practice Address - Country:US
Practice Address - Phone:318-329-3933
Practice Address - Fax:318-322-1134
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10988R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1653489Medicaid
F94666Medicare UPIN
LA5U872CY61Medicare PIN
LA5U872Medicare ID - Type Unspecified