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1558003061

NPI Code Detail

MEDICARE: DR. SANKETH SUKESH MD

MEDICARE: DR. SANKETH SUKESH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	MD491559	PA

General Provider Information

NPI Number	:	1558003061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANKETH SUKESH MD

Provider Business Mailing Address
First Line	:	10938 VALLEY SPRING DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-3732
Country	:	US
Telephone Number	:	704-315-7054
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 S 5TH AVE OFC M1
Second Line	:
City	:	WEST READING
State	:	PA
Zip	:	19611-2143
Country	:	US
Telephone Number	:	484-628-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	04/05/2026

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Directions to “ DR. SANKETH SUKESH MD” Practice Location

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