Provider Demographics
NPI:1750481909
Name:KUNDU, SAMBHU NATH (MD)
Entity Type:Individual
Prefix:
First Name:SAMBHU
Middle Name:NATH
Last Name:KUNDU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6343 STEPHENS CROSSING
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2347
Mailing Address - Country:US
Mailing Address - Phone:717-697-1076
Mailing Address - Fax:
Practice Address - Street 1:6343 STEPHENS XING
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2347
Practice Address - Country:US
Practice Address - Phone:717-697-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035288L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C29455Medicare UPIN
PAKU88423Medicare ID - Type Unspecified