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General NPI Number Information
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NPI Number | 1194935155
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Entity Type | Individual
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Provider Name | SUNITHA A GHANTA MD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 185 WHITESPORT DR SW STE 1
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6487
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Country | US
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Telephone | 562-131-0312
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Fax | 7-651-2298
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Provider Business Mailing Address
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Address Line | 185 WHITESPORT DR SW STE 1
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6487
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Country | US
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Telephone | 256-213-1031
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Fax | 800-765-1229
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.29797
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License Number State | AL
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