1629359427 NPI number — DR. HUNDE SADO TULU M.D.

Table of content: SHAUN TOUSSAINT (NPI 1093688970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629359427 NPI number — DR. HUNDE SADO TULU M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TULU
Provider First Name:
HUNDE
Provider Middle Name:
SADO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629359427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CORPORATE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70508-3870
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-893-9698
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ARH LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOW MOOR
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-862-6011
Provider Business Practice Location Address Fax Number:
540-862-6472
Provider Enumeration Date:
09/07/2011

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: 207P00000X , with the licence number:  0101261772 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: D79191 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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