Individual
DR. KALYANA SUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
419 EAST DONALD STREET, WATERLOO, IA 50703-1223
(319) 236-1911
(319) 287-5832
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 235-5390
(319) 233-1630
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
29047
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4107003
—
IA
01
—
421417307A5
JOHN DEERE HEALTH INS PLA
IA
01
—
58342
WELLMARK INS PLAN
IA
Enumeration date
05/18/2006
Last updated
03/15/2022
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