Healthcare Provider Details

I. General information

NPI: 1922925007
Provider Name (Legal Business Name): SUNDAS DILDAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

906 E SHIAWASSEE ST APT 16
LANSING MI
48912-1533
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-2157
  • Fax:
Mailing address:
  • Phone: 647-394-3965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4351056263
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: