Basic Information
| Provider Information | |||||||||
| NPI: | 1922310580 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUNDARAMOORTHY | ||||||||
| FirstName: | ABIRAMMY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24701 EUCLID AVE | ||||||||
| Address2: | THIRD FLOOR BILLING SERVICES | ||||||||
| City: | EUCLID | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441171714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405997466 | ||||||||
| FaxNumber: | 4405936498 | ||||||||
| Practice Location | |||||||||
| Address1: | 167 W MAIN RD | ||||||||
| Address2: | |||||||||
| City: | CONNEAUT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440302057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405997466 | ||||||||
| FaxNumber: | 4405936498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2010 | ||||||||
| LastUpdateDate: | 10/24/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 35-121986 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.