Provider Demographics
NPI:1871553263
Name:DUNDOO, LAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:
Last Name:DUNDOO
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 1:2016 VADALABENE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062-6901
Mailing Address - Country:US
Mailing Address - Phone:618-288-2970
Mailing Address - Fax:618-288-3572
Practice Address - Street 1:2016 VADALABENE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-6901
Practice Address - Country:US
Practice Address - Phone:618-288-2970
Practice Address - Fax:618-288-3572
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108109207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO108109OtherSTATE LICENSE NUMBER
MO108109OtherSTATE LICENSE NUMBER