MEDICARE: UDAYA BHASKARA RAO SUNKARA 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	208600000X	Surgery Physician	D21187	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578542593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UDAYA BHASKARA RAO SUNKARA MD

Provider Business Mailing Address
First Line	:	11038 DORSCH FARM RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6299
Country	:	US
Telephone Number	:	443-812-0900
Fax Number	:	410-747-1866

Provider Business Practice Location Address
First Line	:	11038 DORSCH FARM RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-6299
Country	:	US
Telephone Number	:	443-812-0900
Fax Number	:	410-747-1866

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	10/29/2018

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