Provider Demographics
NPI:1518497460
Name:PITTAPPILLY, MATTHEW BABU (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:BABU
Last Name:PITTAPPILLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE # 8545
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-5352
Mailing Address - Fax:504-988-1909
Practice Address - Street 1:1430 TULANE AVE # 8545
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-5352
Practice Address - Fax:504-988-1909
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program