Individual
DR. LILY KRISTINE SUNIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D,
Contact information
Practice address
710 PARK PL, MISHAWAKA, IN 46545-3519
(574) 273-6767
(574) 273-6757
Mailing address
PO BOX 5909, PORTLAND, OR 97228-5909
(574) 273-6767
(574) 968-7160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01073784A
IN
207R00000X
Internal Medicine Physician
4301094169
MI
207RN0300X
Nephrology Physician
Primary
01073784A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201235040
—
IN
Enumeration date
07/31/2009
Last updated
04/02/2020
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