Individual
SUE PALLEKONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MBBS
Contact information
Practice address
9820 E 141ST ST STE 100, FISHERS, IN 46038-9303
(317) 794-2432
(317) 799-9669
Mailing address
6340 WOBURN DR, INDIANAPOLIS, IN 46250-2742
(317) 599-7681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01058024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329169
ANTHEM
IN
01
—
P00249958
RR MEDICARE
IN
Enumeration date
07/26/2006
Last updated
08/27/2023
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