Provider Demographics
NPI:1538138037
Name:SINNATHAMBY, SUKIRTHARAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUKIRTHARAN
Middle Name:
Last Name:SINNATHAMBY
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 1:5538 PHILADELPHIA DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3062
Mailing Address - Country:US
Mailing Address - Phone:937-424-3589
Mailing Address - Fax:937-424-0093
Practice Address - Street 1:5538 PHILADELPHIA DR
Practice Address - Street 2:SUITE 4
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3062
Practice Address - Country:US
Practice Address - Phone:937-424-3589
Practice Address - Fax:937-424-0093
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061440207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2052246Medicaid
OH2052246Medicaid
OHSI4205392Medicare PIN