Provider Demographics
NPI:1427197417
Name:NIOGUY, SUNANDA (MD)
Entity Type:Individual
Prefix:
First Name:SUNANDA
Middle Name:
Last Name:NIOGUY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2581
Mailing Address - Country:US
Mailing Address - Phone:248-968-2500
Mailing Address - Fax:248-968-2501
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:SUITE 240
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2581
Practice Address - Country:US
Practice Address - Phone:248-968-2500
Practice Address - Fax:248-968-2501
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2006-02052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology