Provider Demographics
NPI:1417104084
Name:SUNERH, AMANDIP (MD)
Entity Type:Individual
Prefix:
First Name:AMANDIP
Middle Name:
Last Name:SUNERH
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 1:3601 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6712
Mailing Address - Country:US
Mailing Address - Phone:248-423-2454
Mailing Address - Fax:248-423-2576
Practice Address - Street 1:112 WOODGREEN DR.
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:ONTARIO
Practice Address - Zip Code:L4L 7H9
Practice Address - Country:CA
Practice Address - Phone:905-850-1369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092740208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice