Provider Demographics
NPI:1457856809
Name:GUNDAPANENI, LAKSHMI SAROJA
Entity Type:Individual
Prefix:
First Name:LAKSHMI SAROJA
Middle Name:
Last Name:GUNDAPANENI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAKSHMI SAROJA
Other - Middle Name:
Other - Last Name:TUMMALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBS
Mailing Address - Street 1:30117 SCHOENHERR RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6854
Mailing Address - Country:US
Mailing Address - Phone:586-751-8844
Mailing Address - Fax:586-751-8596
Practice Address - Street 1:30117 SCHOENHERR RD STE 100
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6854
Practice Address - Country:US
Practice Address - Phone:586-751-8844
Practice Address - Fax:586-751-8596
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program