Provider Demographics
NPI:1104909605
Name:SUNEJA, SIDNEY KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:KUMAR
Last Name:SUNEJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 OSAGE LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-4405
Mailing Address - Country:US
Mailing Address - Phone:301-229-3562
Mailing Address - Fax:
Practice Address - Street 1:8215 OSAGE LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-4405
Practice Address - Country:US
Practice Address - Phone:301-229-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD12216207U00000X, 2085R0202X
MDD24815207U00000X, 2085R0202X
LAMD06798R207U00000X, 2085R0202X
VA0101047688207U00000X, 2085R0202X
PAMD064853L207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB89307Medicare UPIN