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General NPI Number Information
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NPI Number | 1528690864
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Entity Type | Individual
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Provider Name | ALIA SUNDERJI MD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 615 N WOLFE ST
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City | BALTIMORE
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State | MD
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Zip | 21205-2103
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Country | US
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Telephone | 443-714-9642
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Fax |
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Provider Business Mailing Address
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Address Line | 610 CATHEDRAL ST APT 2
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City | BALTIMORE
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State | MD
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Zip | 21201-5109
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Country | US
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Telephone | 443-714-9642
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Fax |
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | D0088799
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License Number State | MD
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