Provider Demographics
NPI:1598742223
Name:SAHOO, SUNATI (MD)
Entity Type:Individual
Prefix:
First Name:SUNATI
Middle Name:
Last Name:SAHOO
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 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9073
Mailing Address - Country:US
Mailing Address - Phone:214-590-8607
Mailing Address - Fax:214-590-1473
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9073
Practice Address - Country:US
Practice Address - Phone:214-590-8607
Practice Address - Fax:214-590-1473
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37980207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64-081839Medicaid
IN200456080OtherMEDICAID
KY0285231Medicare ID - Type Unspecified
KY64-081839Medicaid