MEDICARE: SUMATHI SUNDAR 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	208000000X	Pediatrics Physician	C10007776	DE
2	208D00000X	General Practice Physician	C10007776	DE
3	208000000X	Pediatrics Physician	MD427867	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1902871239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMATHI SUNDAR MD

Provider Business Mailing Address
First Line	:	817 E BALTIMORE PIKE STE A
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-1929
Country	:	US
Telephone Number	:	610-444-0113
Fax Number	:	610-444-0744

Provider Business Practice Location Address
First Line	:	817 E BALTIMORE PIKE STE A
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-1929
Country	:	US
Telephone Number	:	610-444-0113
Fax Number	:	610-444-0744

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	10/19/2022

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Directions to “ SUMATHI SUNDAR MD” Practice Location

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