Provider Demographics
NPI:1124481262
Name:POTHUGANTI, SAHITHI (MD)
Entity type:Individual
Prefix:
First Name:SAHITHI
Middle Name:
Last Name:POTHUGANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S UNIVERSITY AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5210
Mailing Address - Country:US
Mailing Address - Phone:501-255-2482
Mailing Address - Fax:501-207-8637
Practice Address - Street 1:410 S UNIVERSITY AVE STE 160
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5210
Practice Address - Country:US
Practice Address - Phone:501-255-2482
Practice Address - Fax:501-207-8637
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-12527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine