Provider Demographics
NPI:1205094489
Name:EKE, SANCAR (MD)
Entity type:Individual
Prefix:
First Name:SANCAR
Middle Name:
Last Name:EKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 5TH ST SE STE 3500
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4687
Mailing Address - Country:US
Mailing Address - Phone:253-697-4740
Mailing Address - Fax:253-697-4744
Practice Address - Street 1:1450 5TH ST SE STE 3500
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4687
Practice Address - Country:US
Practice Address - Phone:253-697-4740
Practice Address - Fax:253-697-4744
Is Sole Proprietor?:No
Enumeration Date:2008-05-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301089957207RN0300X
WAMD60271258207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV03810016252Medicaid
WVEK4273261OtherINDIVIDUAL MEDICARE PROVIDER NUMBER
WV23394OtherSTATE LICENSE
WVFE1428691OtherDEA