Individual
DR. BALASASIKUMAR SUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-5011
(479) 441-4932
Mailing address
1543 FIANNA PLACE TER, FORT SMITH, AR 72908-8582
(479) 648-6714
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E4251
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156990001
—
AR
05
—
200117580A
—
OK
01
—
E4251
ARKANSAS STATE LICENSE
AZ
Enumeration date
05/08/2006
Last updated
03/07/2023
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