MEDICARE: DR. SANKAR NAIDU ADUSUMILLI 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	200701309	NC
2	208C00000X	Colon & Rectal Surgery Physician	2007-01309	NC

General Provider Information

NPI Number	:	1639161227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANKAR NAIDU ADUSUMILLI MD

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

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

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	06/11/2026

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