Healthcare Provider Details

I. General information

NPI: 1366698730
Provider Name (Legal Business Name): SUNITHA SEQUEIRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2008
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 SUTTON RD S STE 201
FORT MILL SC
29715-8439
US

IV. Provider business mailing address

6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US

V. Phone/Fax

Practice location:
  • Phone: 803-547-3800
  • Fax: 803-547-3803
Mailing address:
  • Phone: 704-295-3000
  • Fax: 704-295-3468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number96048
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2026-00093
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: