Healthcare Provider Details

I. General information

NPI: 1336327212
Provider Name (Legal Business Name): APARNA SUNDARAM D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14973 W BELL RD STE 100
SURPRISE AZ
85374-3878
US

IV. Provider business mailing address

14973 W BELL RD STE 100
SURPRISE AZ
85374-3878
US

V. Phone/Fax

Practice location:
  • Phone: 623-815-2900
  • Fax: 623-588-1319
Mailing address:
  • Phone: 623-815-2900
  • Fax: 623-588-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number005177
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number005177
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: