Provider Demographics
NPI:1265641518
Name:GUNDA, SARIKA SHAROD (MD)
Entity Type:Individual
Prefix:DR
First Name:SARIKA
Middle Name:SHAROD
Last Name:GUNDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 W GLORIA SWITCH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-2309
Mailing Address - Country:US
Mailing Address - Phone:337-886-6455
Mailing Address - Fax:
Practice Address - Street 1:1516 CHEMIN METAIRIE ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5382
Practice Address - Country:US
Practice Address - Phone:337-856-6880
Practice Address - Fax:337-856-6838
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.203176207Q00000X
LA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1505714Medicaid