Healthcare Provider Details

I. General information

NPI: 1669318762
Provider Name (Legal Business Name): SAMHITA SUNKARA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BLYTHE BLVD
CHARLOTTE NC
28203-5812
US

IV. Provider business mailing address

7394 OLDENBURG LN
PORTAGE MI
49024-3036
US

V. Phone/Fax

Practice location:
  • Phone: 704-355-2165
  • Fax: 704-355-8856
Mailing address:
  • Phone: 269-910-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: