Provider Demographics
NPI:1942324918
Name:THOMPSON, SUDHA SWAMY (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHA
Middle Name:SWAMY
Last Name:THOMPSON
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 1:276 WINTER HILL PL
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8642
Mailing Address - Country:US
Mailing Address - Phone:614-799-2318
Mailing Address - Fax:
Practice Address - Street 1:19900 STATE ROUTE 739
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9256
Practice Address - Country:US
Practice Address - Phone:937-642-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH066958204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine