Sudhir Walavalkar, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301041018 Issued in MI

Practice address

22255 Greenfield Rd
310
Southfield, MI 48075-3710

Phone

(248) 849-4990

Fax

(248) 849-4991

NPI assigned

Jan 3, 2006

Last updated

Dec 29, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: sudhir.walavalkar.1@14250.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1730167552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25925 TELEGRAPH RD",
            "address_2": "210",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332518",
            "telephone_number": "248-746-3218",
            "fax_number": "248-746-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD",
            "address_2": "310",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753710",
            "telephone_number": "248-849-4990",
            "fax_number": "248-849-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALAVALKAR",
        "first_name": "SUDHIR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041018",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "SW041018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl Gordon Wagner Jr., PA-C
• Madison Wagner
• Megan Wagner
• Jessica Anne Wahby, FNP-BC
• Annette L Wahl, NP
• Charnice Walden
• Craig Waldie, CRNA
• Walgreen Co (Walgreens #07208)
• Walgreen Co (Walgreens #21364)
• Walgreen Co (Walgreens #05969)

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.