Provider Demographics
NPI:1326496688
Name:PAUDEL, SUNIL DARSHAN (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:DARSHAN
Last Name:PAUDEL
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 1:2500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-3402
Mailing Address - Country:US
Mailing Address - Phone:304-264-1000
Mailing Address - Fax:
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401
Practice Address - Country:US
Practice Address - Phone:304-264-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2019-10-15
Deactivation Date:2017-01-20
Deactivation Code:
Reactivation Date:2017-03-13
Provider Licenses
StateLicense IDTaxonomies
WV28527207R00000X
OH57.027603390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine