Provider Demographics
NPI:1285252510
Name:SUN CITY INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:SUN CITY INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIDYA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-248-5939
Mailing Address - Street 1:PO BOX 10790
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85318-0790
Mailing Address - Country:US
Mailing Address - Phone:623-248-5939
Mailing Address - Fax:623-248-6709
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 108
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3047
Practice Address - Country:US
Practice Address - Phone:623-248-5939
Practice Address - Fax:623-248-5939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty