Ganapathi Gottumukkala
NPI #1962457614 in Tinley Park, Illinois
Provider Information
- NPI Number
- 1962457614
- Entity Type
- Organization
- Organization Name
- Ganapathi Gottumukkala
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 23, 2006
- Last Updated
- Nov 25, 2009
Practice Location
- Address
- 6701 159TH ST
- Address 2
- SUITE B
- City
- Tinley Park
- State
- Illinois
- ZIP Code
- 60477-1758
- Phone
- (708) 614-0893
Authorized Official
- Name
- GANAPATHI GOTTUMUKKALA, M.D.
- Title
- SOLE PROPRIETOR
- Phone
- (708) 614-0893
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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