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Individual

SUNIL BABU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 484-8830
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
01064887A
IN
207RX0202X
Medical Oncology Physician
Primary
01064887A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000083731
ANTHEM
IN
01
000000565900
ANTHEM PIN
IN
01
000000693541
ANTHEM
IN
05
200901470
IN
05
3044904
OH
Enumeration date
04/04/2008
Last updated
05/15/2025
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