1639161227 NPI number — DR. SANKAR NAIDU ADUSUMILLI MD

Table of content: DR. SANKAR NAIDU ADUSUMILLI MD (NPI 1639161227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639161227 NPI number — DR. SANKAR NAIDU ADUSUMILLI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADUSUMILLI
Provider First Name:
SANKAR
Provider Middle Name:
NAIDU
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADUSUMILLI
Provider Other First Name:
SANKAR
Provider Other Middle Name:
NAIDU
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1639161227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2501 ATRIUM DR
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27607-6452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-235-0216
Provider Business Mailing Address Fax Number:
919-235-0217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 ATRIUM DR
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27607-6452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-235-0216
Provider Business Practice Location Address Fax Number:
919-235-0217
Provider Enumeration Date:
08/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208C00000X , with the licence number:  2007-01309 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 200701309 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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