Provider Demographics
NPI:1003149568
Name:SUD, PAMELA RANI (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:RANI
Last Name:SUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 GLENWOOD DRIVE
Mailing Address - Street 2:SUITE E-500
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404
Mailing Address - Country:US
Mailing Address - Phone:423-495-2635
Mailing Address - Fax:423-495-2638
Practice Address - Street 1:725 GLENWOOD DRIVE
Practice Address - Street 2:SUITE E-500
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-495-2635
Practice Address - Fax:423-495-2638
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28517207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH55446Medicare UPIN