Provider Demographics
NPI:1265750897
Name:SHEKAR, SUMAN (MD)
Entity type:Individual
Prefix:
First Name:SUMAN
Middle Name:
Last Name:SHEKAR
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 1:1901 SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3303
Mailing Address - Country:US
Mailing Address - Phone:270-901-0629
Mailing Address - Fax:270-901-0892
Practice Address - Street 1:1901 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3303
Practice Address - Country:US
Practice Address - Phone:270-901-0629
Practice Address - Fax:270-901-0892
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48337208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine