Healthcare Provider Details

I. General information

NPI: 1982382008
Provider Name (Legal Business Name): FNU SANGAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. SANGAM SANGAM

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ELM AND CARLTON ST
BUFFALO NY
14263-0001
US

IV. Provider business mailing address

ELM AND CARLTON ST
BUFFALO NY
14263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 716-845-2300
  • Fax:
Mailing address:
  • Phone: 716-845-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number345122
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: