Provider Demographics
NPI:1194706143
Name:ADUSUMILLI, SANDHYA K (MD)
Entity type:Individual
Prefix:
First Name:SANDHYA
Middle Name:K
Last Name:ADUSUMILLI
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2108 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-299-1301
Mailing Address - Fax:717-299-2214
Practice Address - Street 1:2108 HARRISBURG PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-299-1301
Practice Address - Fax:717-299-2214
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2024-10-25
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Provider Licenses
StateLicense IDTaxonomies
PAMD420344207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010584380001Medicaid
PA91244 659TOtherGEISINGER HEALTH PLAN
PAI16055OtherHEALTH ASSURANCE
PA1541123OtherGATEWAY HEALTH PLAN
PA50040146OtherCAPITAL BLUE CROSS
PA1652825OtherHIGHMARK BLUE SHIELD
PA7319664OtherAETNA NON-HMO
PA3975372OtherAETNA HMO
PAP00141597OtherRAILROAD MEDICARE
PA1652825OtherHIGHMARK BLUE SHIELD
PAI16055Medicare UPIN