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General NPI Number Information
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NPI Number | 1831496942
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Entity Type | Individual
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Provider Name | SUSHRUT SUNIL DHARMADHIKARI MD
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Gender | Male
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 21212 NORTHWEST FWY STE 645A
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City | CYPRESS
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State | TX
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Zip | 77429-6070
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Country | US
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Telephone | 281-894-5310
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Fax | 281-894-5313
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Provider Business Mailing Address
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Address Line | 5340 BENTLEY RD APT 104
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2186
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Country | US
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Telephone | 330-503-8301
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | E-10455
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD-61582983
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | C176123
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 01089709A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | E-10455
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License Number State | AR
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Taxonomy #6
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | T5297
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | E-10455
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License Number State | AR
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Taxonomy #8
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | E-10455
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License Number State | AR
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Taxonomy #9
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | DR.0067274
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License Number State | CO
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Taxonomy #10
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | T5297
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License Number State | TX
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Taxonomy #11
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | T5297
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License Number State | TX
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