Indu Mago Sud, MD
Individual provider Active NPI Addiction Medicine (Psychiatry & Neurology) Physician · Ashton, MD
NPI 1174634869 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1174634869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
- License
- D0020769 (MD)
- Practice address
- 17958 Pond Rd
Ashton, MD 20861-9756 - Phone
- (301) 774-1987
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| WJWR Physicians Associates Inc | Past |
Accepting new patients | |
| Samuel Berkowitz, PH.D., Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | D0020769 | MD | Yes |
Addresses
Primary practice location
17958 Pond Rd
Ashton, MD 20861-9756
Mailing address
17958 Pond Rd
Ashton, MD 20861-9756
Other providers in Ashton, MD
- Angelo Gayheart Pope Jr.
- Lauren Emily Robertson
- Curtis Rosebraugh
- Shore Health Services LLC
- Beenish Siddique
- Nancy Takahashi
- Kathy Wu
- Danice Young
All providers in Ashton, MD · Addiction Medicine (Psychiatry & Neurology) Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.