Provider Demographics
NPI:1982675567
Name:UMMAT, SUNIL K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:K
Last Name:UMMAT
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 1:3100 CARILLON POINT
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7306
Mailing Address - Country:US
Mailing Address - Phone:425-576-1700
Mailing Address - Fax:425-827-7725
Practice Address - Street 1:3100 CARILLON POINT
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7306
Practice Address - Country:US
Practice Address - Phone:425-576-1700
Practice Address - Fax:425-827-7725
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18874174400000X
WAMD00046397207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT24738Medicaid
WAG30141Medicare UPIN
SCT24738Medicaid