# SUDHIR BANSAL, MD INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932424645
- **Authorized official:** DOREEN M MORENCY (OFFICE MANAGER)
- **Authorized official phone:** (401) 732-6828

## Contact information

- **Practice address:** 215 TOLL GATE RD, SUITE 309/310, WARWICK, RI 02886-4458
- **Practice address phone:** (401) 732-6828
- **Practice address fax:** (401) 223-3040
- **Mailing address:** 215 TOLL GATE RD, SUITE 309/310, WARWICK, RI 02886-4458
- **Mailing address phone:** (401) 732-6828
- **Mailing address fax:** (401) 223-3040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | RI6157 | RI | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | RI7603 | RI | Yes |

## Other

- **Enumeration date:** 04/06/2010
- **Last updated:** 04/06/2010