Provider Demographics
NPI:1265476097
Name:ARUMANLA, SUDHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHIR
Middle Name:
Last Name:ARUMANLA
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 1:501 S BALLENGER HWY
Mailing Address - Street 2:STE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3641
Mailing Address - Country:US
Mailing Address - Phone:810-342-4800
Mailing Address - Fax:
Practice Address - Street 1:700 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4924
Practice Address - Country:US
Practice Address - Phone:903-269-8093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14431592085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI300B560780OtherBCBS
MI5215070Medicaid