Provider Demographics
NPI:1225230949
Name:PAUDYAL, SUNITA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:
Last Name:PAUDYAL
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:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:2 MEDICAL PARK ROAD
Practice Address - Street 2:SUITE 501
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-540-1000
Practice Address - Fax:803-540-1075
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39206207R00000X, 207RR0500X
ORMD126236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC39206OtherLICENSE
ORMD126236OtherOR MEDICAL BOARD
SC392060Medicaid