Individual
DR. BASKARAN SUNDARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MB, BS
Contact information
Practice address
111 S 11TH ST, SUITE 3390, PHILADELPHIA, PA 19107-4824
(215) 955-6226
(215) 923-1562
Mailing address
111 S 11TH ST, SUITE 3390, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301081071
MI
2085R0202X
Diagnostic Radiology Physician
Primary
MD450483
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4507375
—
MI
Enumeration date
10/18/2006
Last updated
04/01/2014
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