Individual
SOPHIA SUNDARARAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3192
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35-075624
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221273
UNISON
OH
01
—
000000510688
ANTHEM
OH
01
—
130023655
MCR RR
—
05
—
2240631
—
OH
01
—
364065
WELLCARE MEDICAID
OH
01
—
741882
BUCKEYE MEDICAID
OH
01
—
7580306
AETNA
OH
01
—
P00412364
RAILROAD MEDICARE
OH
Enumeration date
07/17/2006
Last updated
12/03/2020
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