Provider Demographics
NPI:1609569870
Name:POTHACAMURI, ANTHONY MOUNICA (MD)
Entity Type:Individual
Prefix:MS
First Name:ANTHONY MOUNICA
Middle Name:
Last Name:POTHACAMURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOUNICA
Other - Middle Name:ANTHONY
Other - Last Name:POTHACAMURI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4000 JOHNSON RD,
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952
Mailing Address - Country:US
Mailing Address - Phone:740-264-8000
Mailing Address - Fax:
Practice Address - Street 1:4000 JOHNSON RD,
Practice Address - Street 2:TRINITY HOSPITAL EAST
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952
Practice Address - Country:US
Practice Address - Phone:740-264-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program