Individual
DR. SUNANDA GHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
Mailing address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2010003235
MO
208600000X
Surgery Physician
BP10017554
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
787000019
MEDICARE
MO
Enumeration date
12/06/2007
Last updated
11/15/2021
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