Provider Demographics
NPI:1538955034
Name:PULUMATI, ANIKA
Entity type:Individual
Prefix:
First Name:ANIKA
Middle Name:
Last Name:PULUMATI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 WHISPERING HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63038
Mailing Address - Country:US
Mailing Address - Phone:636-236-6046
Mailing Address - Fax:
Practice Address - Street 1:1663 WHISPERING HOLLOW CT
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63038
Practice Address - Country:US
Practice Address - Phone:636-236-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program