Individual
BANU SUNDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,
Contact information
Practice address
55 LAKE AVENUE NORTH, WORCETER, MA 01655-2029
(508) 856-2527
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
206124
MA
2084N0400X
Neurology Physician
Primary
60390
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2109522
—
MA
Enumeration date
02/22/2006
Last updated
02/06/2019
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