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General NPI Number Information
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NPI Number | 1720952773
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Entity Type | Individual
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Provider Name | SUNKU BALRAJ SAIKUMAR
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Gender | Male
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1300 CUMMINS RD STE 112
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City | DES MOINES
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State | IA
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Zip | 50315-5978
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Country | US
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Telephone | 609-721-1542
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 CUMMINS RD STE 112
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City | DES MOINES
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State | IA
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Zip | 50315-5978
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Country | US
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Telephone |
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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