Basic Information
| Provider Information | |||||||||
| NPI: | 1083646764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADMAL | ||||||||
| FirstName: | SUDERSHAN | ||||||||
| MiddleName: | REDDY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O BOX 69004 | ||||||||
| Address2: | V.A MEDICAL CENTER | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713069004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184730010 | ||||||||
| FaxNumber: | 3184835065 | ||||||||
| Practice Location | |||||||||
| Address1: | V.A MEDICAL CENTER | ||||||||
| Address2: | SHREVEPORT HIGHWAY | ||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713069004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184730010 | ||||||||
| FaxNumber: | 3184835065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 05327R | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.