Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 27974 | NE |
NPI | 1043290992 |
---|---|
Provider Name | Umasankari Sundaram |
First Address | Omaha, NE 68103-0755 |
Second Address | Omaha, NE 68114-3654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 30/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10026480118 | (05) | NE |
1043290992 | (05) | IA |
I33779 | (02) |