Provider Demographics
NPI:1407838188
Name:GODIWALA, SUNITA N (MD, FAAFP)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:N
Last Name:GODIWALA
Suffix:
Gender:F
Credentials:MD, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAYO DR
Mailing Address - Street 2:UNIT-B
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1539
Mailing Address - Country:US
Mailing Address - Phone:508-829-5599
Mailing Address - Fax:
Practice Address - Street 1:11 MAYO DR
Practice Address - Street 2:UNIT-B
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-1539
Practice Address - Country:US
Practice Address - Phone:508-829-5599
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine