Provider Demographics
NPI:1215084504
Name:SUNDRAM, UMA NARAYANI (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:UMA
Middle Name:NARAYANI
Last Name:SUNDRAM
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:STE. 3D
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1867
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:BEAUMONT HEALTH-ANATOMIC PATHOLOGY
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-898-9060
Practice Address - Fax:248-898-9054
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2019-01-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301108669207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH85703Medicare UPIN