Basic Information
| Provider Information | |||||||||
| NPI: | 1881839173 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARIKRISHNAN | ||||||||
| FirstName: | SUNDARAM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 542 RIMINI VISTA WAY | ||||||||
| Address2: | |||||||||
| City: | SUN CITY CENTER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335734435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136428710 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3622 BELMONT AVE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445051450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307599350 | ||||||||
| FaxNumber: | 3307599387 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2008 | ||||||||
| LastUpdateDate: | 01/19/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35045745 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 14517 | NE | N | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.