Sudha Bansal, M.D.
Individual provider Active NPI Family Medicine Physician · Adrian, MI
NPI 1922053008 · NPPES record last updated Mar 14, 2012
Key facts
- NPI
- 1922053008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301404631 (MI)
- Practice address
- 415 Mill Rd
Adrian, MI 49221-1764 - Phone
- (517) 264-5820
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301404631 | MI | Yes |
Addresses
Primary practice location
415 Mill Rd
Adrian, MI 49221-1764
Mailing address
PO Box 1476
Adrian, MI 49221-7476
Phone (517) 264-5820
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4500632 | Medicaid | MI |
Other providers in Adrian, MI
- Abigail Baker
- Joseph Baker
- Katie J Baker
- Elizabeth A Baldwin
- Sean Patrick Balfour
- Bapa101 PLLC
- Sandra Kay Barancin
- Tamra Beth Barbieri
- Sarah Emma Barker
- Valerie S Barker
All providers in Adrian, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2012. 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.