MEDICARE: SUNU GEORGE 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	207Q00000X	Family Medicine Physician	01059202A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00459132	OTHER	IN	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215930318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNU GEORGE M.D.

Provider Business Mailing Address
First Line	:	916 E MAIN STREET
Second Line	:	SUITE 100
City	:	GREENWOOD
State	:	IN
Zip	:	46143-1533
Country	:	US
Telephone Number	:	317-889-0900
Fax Number	:	317-889-0922

Provider Business Practice Location Address
First Line	:	916 E MAIN STREET
Second Line	:	SUITE 100
City	:	GREENWOOD
State	:	IN
Zip	:	46143-1533
Country	:	US
Telephone Number	:	317-889-0900
Fax Number	:	317-889-0922

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/11/2012

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Directions to “ SUNU GEORGE M.D.” Practice Location

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