Healthcare Provider Details

I. General information

NPI: 1841751146
Provider Name (Legal Business Name): SUNDARACHALAM PINDICURA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 S WASHINGTON AVE
SAGINAW MI
48601-2564
US

IV. Provider business mailing address

1000 HOUGHTON AVE
SAGINAW MI
48602-5303
US

V. Phone/Fax

Practice location:
  • Phone: 989-790-1001
  • Fax: 989-790-1002
Mailing address:
  • Phone: 989-558-6425
  • Fax: 989-746-7723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301517797
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: