Individual
DR. VIJAYENDRA H SUDHEENDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
690 CANTON ST, SUITE 325, WESTWOOD, MA 02090-2321
(781) 407-7713
(781) 407-0998
Mailing address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-4575
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD11054
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2111420
—
MA
05
—
7010488
—
RI
Enumeration date
07/21/2005
Last updated
10/15/2007
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