Most Relevant Information
Provider Data
| NPI Number: | 1003490426 |
| Provider Name: | SUSHMITA THOTA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 208000000X |
| Specialty: | Pediatrics |
| License Number: | 2024026869 |
Most Important Dates
| Enumeration Date: | 05/11/2021 |
| Last Updated: | 10/09/2024 |
Provider Practice Location
2879 JAMES BLVD
POPLAR BLUFF
MO
639013395
Practice Location Phone/Fax
| Phone: | 2145668275 |
| Fax: |
Provider Mailing Location
205 MACINTOSH LN
POPLAR BLUFF
MO
639019116
Provider Mailing Phone/Fax
| Phone: | 2145668275 |
| Fax: |
Suggested EMR
Pediatrics EMR