Healthcare Provider Details
I. General information
NPI: 1336881838
Provider Name (Legal Business Name): SUMEET BANWAIT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2022
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1520 N SENATE AVE
INDIANAPOLIS IN
46202-2213
US
IV. Provider business mailing address
10722 CLUB CHASE
FISHERS IN
46037-9434
US
V. Phone/Fax
- Phone: 317-963-4634
- Fax:
- Phone: 317-476-2874
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 02008623A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: