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Individual
DR. SUJATA KAMBHATLA
Active
Individual
DR. SUJATA KAMBHATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SK4301067805
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104565305
—
MI
01
—
110827980
BCBS
MI
01
—
1891767281
ORGANIZATIONAL NPI
MI
01
—
383564379
TAX ID
MI
01
—
N20400001
MEDICARE RENDERRING ID
MI
01
—
SK067805
LICENSE NUMBER
MI
Enumeration date
02/24/2007
Last updated
11/07/2022
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