Provider Demographics
NPI:1710960893
Name:PAUL, SUMITA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMITA
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUMITA
Other - Middle Name:
Other - Last Name:CHOWDHURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:600 PROVIDENCE PARK DR E
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4616
Mailing Address - Country:US
Mailing Address - Phone:251-634-1544
Mailing Address - Fax:251-634-0235
Practice Address - Street 1:600 PROVIDENCE PARK DR E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-4616
Practice Address - Country:US
Practice Address - Phone:251-634-1544
Practice Address - Fax:251-634-0235
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-09-01
Deactivation Date:2017-10-11
Deactivation Code:
Reactivation Date:2021-05-10
Provider Licenses
StateLicense IDTaxonomies
ALMD.47223207R00000X, 207RC0000X
FL133478207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE
TX8F21171OtherMEDICARE PTAN
TXH33901Medicare UPIN