Provider Demographics
NPI:1235179698
Name:LAMSAL, SUMAN (MD)
Entity Type:Individual
Prefix:
First Name:SUMAN
Middle Name:
Last Name:LAMSAL
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:PO BOX 729
Mailing Address - Street 2:606 MAIN STREET
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-0729
Mailing Address - Country:US
Mailing Address - Phone:252-745-3191
Mailing Address - Fax:252-745-7385
Practice Address - Street 1:606 MAIN ST
Practice Address - Street 2:
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-9632
Practice Address - Country:US
Practice Address - Phone:252-745-3191
Practice Address - Fax:252-745-7385
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6912425Medicaid
NCH02771Medicare UPIN
NC2279678Medicare PIN