Provider Demographics
NPI:1578517298
Name:HUDEK, SABITHA SUNDERRAO (MD)
Entity Type:Individual
Prefix:DR
First Name:SABITHA
Middle Name:SUNDERRAO
Last Name:HUDEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1417 MARK ALLEN LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5597
Mailing Address - Country:US
Mailing Address - Phone:615-895-7064
Mailing Address - Fax:615-895-7543
Practice Address - Street 1:324 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087
Practice Address - Country:US
Practice Address - Phone:615-554-7401
Practice Address - Fax:615-807-3303
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000203282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3058477Medicare ID - Type UnspecifiedMEDICARE
TNE76298Medicare UPIN