Provider Demographics
NPI:1518927318
Name:SUNDAR INTERNAL MEDICINE ASSOCIATES, PA
Entity Type:Organization
Organization Name:SUNDAR INTERNAL MEDICINE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VEERAPPAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-492-6127
Mailing Address - Street 1:511 RUIN CREEK RD
Mailing Address - Street 2:SUITE:203
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5919
Mailing Address - Country:US
Mailing Address - Phone:252-432-6127
Mailing Address - Fax:
Practice Address - Street 1:511 RUIN CREEK RD
Practice Address - Street 2:SUITE:203
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:252-432-6127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011FEMedicaid
NC2327756Medicare ID - Type Unspecified