Provider Demographics
NPI:1952320236
Name:LAL, SUNIL K (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:K
Last Name:LAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3623 J DEWEY GRAY CIR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-6511
Mailing Address - Country:US
Mailing Address - Phone:706-650-7442
Mailing Address - Fax:706-650-7719
Practice Address - Street 1:3623 J DEWEY GRAY CIR
Practice Address - Street 2:SUITE 210
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6511
Practice Address - Country:US
Practice Address - Phone:706-650-7442
Practice Address - Fax:706-650-7719
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-01-24
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Provider Licenses
StateLicense IDTaxonomies
GA057877207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA179056131CMedicaid
GA511I100057Medicare PIN
GA179056131CMedicaid