Individual
JEANENNE M SUNEJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36282
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0468876
—
IA
01
—
39657
WELLMARK BCBS
IA
Enumeration date
02/15/2006
Last updated
12/18/2007
Update your record
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