Provider Demographics
NPI:1235140682
Name:MATTEGUNTA, SUNEETHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNEETHA
Middle Name:
Last Name:MATTEGUNTA
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:CHERRY HOSPITAL
Mailing Address - Street 2:1401 WEST ASH STREET
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-1078
Mailing Address - Country:US
Mailing Address - Phone:919-735-9710
Mailing Address - Fax:
Practice Address - Street 1:CHERRY HOSPITAL
Practice Address - Street 2:1401 WEST ASH STREET
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1078
Practice Address - Country:US
Practice Address - Phone:919-735-9710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002014932084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH70976Medicare UPIN