Provider Demographics
NPI:1801844295
Name:SADHUKHAN, ANKUR KUMAR (MD)
Entity type:Individual
Prefix:
First Name:ANKUR
Middle Name:KUMAR
Last Name:SADHUKHAN
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 1:505 HISTORIC DRIVE
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17579-1479
Mailing Address - Country:US
Mailing Address - Phone:717-723-1371
Mailing Address - Fax:
Practice Address - Street 1:505 HISTORIC DRIVE
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:PA
Practice Address - Zip Code:17579-1479
Practice Address - Country:US
Practice Address - Phone:717-723-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071234L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018013000002Medicaid
PA158841OtherMEDICARE GROUP NUMBER
PA158841OtherMEDICARE GROUP NUMBER