Provider Demographics
NPI:1154326247
Name:RAMASAMY, SUNDHAR R (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNDHAR
Middle Name:R
Last Name:RAMASAMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5649
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-0649
Mailing Address - Country:US
Mailing Address - Phone:989-797-2400
Mailing Address - Fax:989-249-1035
Practice Address - Street 1:5161 CARDINAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9435
Practice Address - Country:US
Practice Address - Phone:989-797-2400
Practice Address - Fax:989-249-1035
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301061263207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1004153492Medicaid
MI1004153492Medicaid
MIG48469Medicare UPIN