Provider Demographics
NPI:1831496942
Name:DHARMADHIKARI, SUSHRUT SUNIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSHRUT
Middle Name:SUNIL
Last Name:DHARMADHIKARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5340 BENTLEY RD APT 104
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2186
Mailing Address - Country:US
Mailing Address - Phone:330-503-8301
Mailing Address - Fax:
Practice Address - Street 1:21212 NORTHWEST FWY STE 645A
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6070
Practice Address - Country:US
Practice Address - Phone:281-894-5310
Practice Address - Fax:281-894-5313
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-10455207T00000X, 2084N0400X, 2084V0102X, 2085N0700X
CAC1761232084N0400X
IN01089709A2084N0400X
TXT52972084V0102X, 2084N0400X, 2085N0700X
CODR.00672742085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology