Provider Demographics
NPI:1952385601
Name:SUD, PARUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PARUL
Middle Name:
Last Name:SUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:810-342-1000
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:G3230 BEECHER RD STE 2
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3604
Practice Address - Country:US
Practice Address - Phone:810-342-5800
Practice Address - Fax:810-342-5810
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046640207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110B56125OtherBLUE CARE NETWORK
MI2699454005OtherCIGNA
MI110B56125OtherBLUE CROSS BLUE SHIELD
MIC1749OtherMCARE
MI20800747OtherMCLAREN HEALTH PLAN
MI110B56125OtherCOMMUNITY BLUE PPO
MI2800747OtherHEALTH ADVANTAGE NETWORK
MID92605OtherHEALTH NET FEDERAL SERVIC
MI110B56125OtherHEALTH PLUS
MI2800747Medicaid
MI4350402OtherAETNA
MI1102500702OtherBLUE CROSS BLUE SHIELD
MID92605OtherHAP
MI110B56125OtherCOMMUNITY BLUE PPO