Provider Demographics
NPI:1528394269
Name:POTAKAMURI, LAKSHMI NARAYANA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:NARAYANA
Last Name:POTAKAMURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1330 MERCY DR NW STE 101
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2624
Mailing Address - Country:US
Mailing Address - Phone:330-588-4676
Mailing Address - Fax:330-588-4677
Practice Address - Street 1:1330 MERCY DR NW STE 101
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2624
Practice Address - Country:US
Practice Address - Phone:330-588-4676
Practice Address - Fax:330-588-4677
Is Sole Proprietor?:No
Enumeration Date:2009-10-31
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH17589207R00000X
OH35.132749207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine