Provider Demographics
NPI:1366860793
Name:SUNDAR, SRINIKETH (DO)
Entity Type:Individual
Prefix:DR
First Name:SRINIKETH
Middle Name:
Last Name:SUNDAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 SILVERSIDE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1768
Mailing Address - Country:US
Mailing Address - Phone:844-365-7246
Mailing Address - Fax:302-477-1708
Practice Address - Street 1:405 SILVERSIDE RD STE 104
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1768
Practice Address - Country:US
Practice Address - Phone:844-365-7246
Practice Address - Fax:302-477-1708
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0013160207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine