Individual
SUNAY SRINIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-5941
Mailing address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11023108A
IN
Other
Enumeration date
04/21/2022
Last updated
07/23/2023
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