Individual
SUDHEER PENUPOLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 NORTH ACADEMY AVENUE, DANVILLE, PA 17822
(570) 271-6655
(570) 214-3967
Mailing address
100 NORTH ACADEMY AVENUE, DANVILLE, PA 17822
(570) 271-6655
(570) 214-3967
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD454637
PA
207RP1001X
Pulmonary Disease Physician
Primary
MD454637
PA
390200000X
Student in an Organized Health Care Education/Training Program
R73194
AZ
Other
Enumeration date
07/16/2012
Last updated
08/31/2020
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