Provider Demographics
NPI:1720244890
Name:DUVEDI, SUMAN SHARMA (MD)
Entity Type:Individual
Prefix:
First Name:SUMAN
Middle Name:SHARMA
Last Name:DUVEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11200 SCAGGSVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-2024
Mailing Address - Country:US
Mailing Address - Phone:240-360-5992
Mailing Address - Fax:855-371-0566
Practice Address - Street 1:11200 SCAGGSVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-2024
Practice Address - Country:US
Practice Address - Phone:240-360-5992
Practice Address - Fax:855-371-0566
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2020-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0069281208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD024466000Medicaid