Provider Demographics
NPI:1184902348
Name:SUNKARA, PALLAVI (MD)
Entity type:Individual
Prefix:
First Name:PALLAVI
Middle Name:
Last Name:SUNKARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PALLAVI
Other - Middle Name:
Other - Last Name:PEDDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5855 CITRUS BLVD
Mailing Address - Street 2:APT# 213
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-5876
Mailing Address - Country:US
Mailing Address - Phone:716-598-6488
Mailing Address - Fax:
Practice Address - Street 1:17000 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3246
Practice Address - Country:US
Practice Address - Phone:225-236-5932
Practice Address - Fax:225-236-5504
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.204784207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine