MEDICARE: SUNIL SANTHANAKRISHNAN MD

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	207RP1001X	Pulmonary Disease Physician	26044	AZ

General Provider Information

NPI Number	:	1215991617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIL SANTHANAKRISHNAN MD

Provider Business Mailing Address
First Line	:	5090 NORTH 40TH STREET
Second Line	:	SUITE 122
City	:	PHOENIX
State	:	AZ
Zip	:	85018
Country	:	US
Telephone Number	:	602-264-5685
Fax Number	:	602-631-9870

Provider Business Practice Location Address
First Line	:	5090 NORTH 40TH STREET
Second Line	:	SUITE 122
City	:	PHOENIX
State	:	AZ
Zip	:	85018
Country	:	US
Telephone Number	:	602-264-5685
Fax Number	:	602-631-9870

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	08/18/2015

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