MEDICARE: SANDEEP AMESUR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	0101277717	VA
2	2085R0202X	Diagnostic Radiology Physician	506384	TX

General Provider Information

NPI Number	:	1144329848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDEEP AMESUR M.D.

Provider Business Mailing Address
First Line	:	22100 BOTHELL EVERETT HWY
Second Line	:
City	:	BOTHELL
State	:	WA
Zip	:	98021-8431
Country	:	US
Telephone Number	:	208-416-2932
Fax Number	:

Provider Business Practice Location Address
First Line	:	3388 SAGE RD UNIT 2601
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-7200
Country	:	US
Telephone Number	:	713-963-9729
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	08/04/2023

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Directions to “ SANDEEP AMESUR M.D.” Practice Location

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