Provider Demographics
NPI:1639161227
Name:ADUSUMILLI, SANKAR NAIDU (MD)
Entity Type:Individual
Prefix:DR
First Name:SANKAR
Middle Name:NAIDU
Last Name:ADUSUMILLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SANKAR
Other - Middle Name:NAIDU
Other - Last Name:ADUSUMILLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2501 ATRIUM DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6452
Mailing Address - Country:US
Mailing Address - Phone:919-235-0216
Mailing Address - Fax:919-235-0217
Practice Address - Street 1:2501 ATRIUM DR
Practice Address - Street 2:SUITE 305
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6452
Practice Address - Country:US
Practice Address - Phone:919-235-0216
Practice Address - Fax:919-235-0217
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01309208C00000X
NC200701309208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2021834Medicare PIN