Provider Demographics
NPI:1073591970
Name:HUNDAL, RIPUDAMAN S (MD)
Entity Type:Individual
Prefix:
First Name:RIPUDAMAN
Middle Name:S
Last Name:HUNDAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 CHRISTIANA RD STE 109
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4248
Mailing Address - Country:US
Mailing Address - Phone:302-444-8156
Mailing Address - Fax:302-731-8158
Practice Address - Street 1:774 CHRISTIANA RD STE 109
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4248
Practice Address - Country:US
Practice Address - Phone:302-444-8156
Practice Address - Fax:302-731-8158
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10006298207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1073591970Medicaid
DE009274C49Medicare PIN
DEH48070Medicare UPIN
DE008064C04Medicare PIN