Provider Demographics
NPI:1124433727
Name:PAWAR, SUMEET SANJEEV (MD)
Entity type:Individual
Prefix:DR
First Name:SUMEET
Middle Name:SANJEEV
Last Name:PAWAR
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 1:100 PERKINS FARM DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-4041
Mailing Address - Country:US
Mailing Address - Phone:860-572-5400
Mailing Address - Fax:
Practice Address - Street 1:100 PERKINS FARM DR STE 301
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-4041
Practice Address - Country:US
Practice Address - Phone:860-572-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD17081207RC0000X
CT65594207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program