Provider Demographics
NPI:1326304106
Name:PUNIA, SUNDEEP (MD)
Entity Type:Individual
Prefix:
First Name:SUNDEEP
Middle Name:
Last Name:PUNIA
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 1:4964 N CALLE BUJIA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6155
Mailing Address - Country:US
Mailing Address - Phone:443-567-8550
Mailing Address - Fax:
Practice Address - Street 1:3201 S. 6TH AVENUE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718
Practice Address - Country:US
Practice Address - Phone:520-629-1814
Practice Address - Fax:520-629-1779
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50403207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program