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General NPI Number Information
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NPI Number | 1750856902
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Entity Type | Individual
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Provider Name | SUKUMAR GUNDAPANENI
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Gender | Male
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 27800 NORTHWEST FWY STE 4201
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City | CYPRESS
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State | TX
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Zip | 77433-5302
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Country | US
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Telephone | 346-231-4628
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Fax | 346-644-8144
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Provider Business Mailing Address
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Address Line | 37000 GRAND RIVER AVE STE 310
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-2868
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V0409
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301504750
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 57.246895
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | V0409
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License Number State | TX
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