Basic Information
| Provider Information | |||||||||
| NPI: | 1992083372 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VAVILATHOTA | ||||||||
| FirstName: | SUNITHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3500 REGENT CT | ||||||||
| Address2: | |||||||||
| City: | MURRYSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156688520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144265046 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25 HECKEL RD | ||||||||
| Address2: | |||||||||
| City: | MC KEES ROCKS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151361651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127776161 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2011 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD453890 | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.