Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 106247 | MN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD432934 | PA |
NPI | 1205027653 |
---|---|
Provider Name | Dr. Sudip Nanda |
First Address | Bethlehem, PA 18018-2256 |
Second Address | Bethlehem, PA 18018-2256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 21/07/2014 |