Provider Demographics
NPI:1467403667
Name:VYAS, SUNITA N (MD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:N
Last Name:VYAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:508-363-5000
Mailing Address - Fax:508-363-5430
Practice Address - Street 1:123 SUMMER STREET
Practice Address - Street 2:
Practice Address - City:WORCESTOR
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-363-5000
Practice Address - Fax:508-363-5430
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216308207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherPRIVATE HEALTHCARE SYSTEM
8894556OtherCIGNA HEALTH PLAN
J25596OtherBLUE SHIELD INDEMNITY
042472266OtherTHREE RIVERS
57013OtherFALLON COMM HEALTH PLAN
AA6370OtherHARVARD PILGRAM HLTH CARE
0405733OtherEVERCARE
7208645OtherAETNA
MA2027283Medicaid
784100OtherMVP HEALTH CARE
042472266OtherHEALTHCARE VALUE MGMT
042472266OtherONE HEALTH PLAN
042472266OtherCHAMPUS
042472266OtherTRICARE
2120354OtherFIRST HEALTH
7208645OtherUS HEALTHCARE
2027283OtherMEDICAID WELFARE
AA6370OtherHARVARD PILGRAM HLTH CARE
2120354OtherFIRST HEALTH
7208645OtherUS HEALTHCARE