Provider Demographics
NPI:1285011866
Name:NARAYANA, SUMATHI (MD)
Entity Type:Individual
Prefix:
First Name:SUMATHI
Middle Name:
Last Name:NARAYANA
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 1:1491 WOODFERN DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4532
Mailing Address - Country:US
Mailing Address - Phone:508-769-1525
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON PL STE 2600
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4420
Practice Address - Country:US
Practice Address - Phone:860-918-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-02
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS28075207Q00000X
AL41441207Q00000X
GA86656207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine