Provider Demographics
NPI:1992559017
Name:BILLA LALITHA RAMESH, SATHWIK (MD)
Entity type:Individual
Prefix:DR
First Name:SATHWIK
Middle Name:
Last Name:BILLA LALITHA RAMESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 ROBLEY DRIVE APT 3206
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-261-6166
Mailing Address - Fax:337-261-6129
Practice Address - Street 1:2390 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4205
Practice Address - Country:US
Practice Address - Phone:337-261-6166
Practice Address - Fax:337-261-6129
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-12-23
Deactivation Date:2024-11-29
Deactivation Code:
Reactivation Date:2024-12-23
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA342644207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program