Dr. Sujitha Nandimandalam, M.D.
Internal Medicine in Tyler, TX. Individual provider (NPI-1).
NPI number1114334752
StatusActive
Last updated in NPPESSep 10, 2021
Details
- NPI
- 1114334752
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sujitha Nandimandalam
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 15, 2014
- Certification date
- Sep 10, 2021
- Last updated
- Sep 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | T0874 | TX | Yes |
| 207R00000X | Internal Medicine | 2015-01901 | NC |
Practice location
1000 S Beckham AveTyler, TX 75701-1908
Phone 903-590-5611 · Fax 903-535-6884
Mailing address
1000 S Beckham AveTyler, TX 75701-1908
Phone 903-590-5611 · Fax 903-535-6884
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