Provider Demographics
NPI:1093045346
Name:MATHUR, SUNJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNJAY
Middle Name:
Last Name:MATHUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5319 HOAG DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1494
Mailing Address - Country:US
Mailing Address - Phone:440-930-6015
Mailing Address - Fax:440-930-6094
Practice Address - Street 1:5319 HOAG DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1494
Practice Address - Country:US
Practice Address - Phone:440-930-6015
Practice Address - Fax:440-930-6094
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-09
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43011024042081P2900X
IL036130393208100000X
OH35.1215322081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation