Provider Demographics
NPI:1669499547
Name:RUMMANI-ASKAR, SUNDUS FATHALLA (MD)
Entity Type:Individual
Prefix:
First Name:SUNDUS
Middle Name:FATHALLA
Last Name:RUMMANI-ASKAR
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 1:26440 HOOVER RD STE C
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1190
Mailing Address - Country:US
Mailing Address - Phone:586-427-1351
Mailing Address - Fax:586-486-5669
Practice Address - Street 1:26440 HOOVER RD STE C
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1190
Practice Address - Country:US
Practice Address - Phone:586-427-1337
Practice Address - Fax:586-427-1332
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4435267Medicaid