Provider Demographics
NPI:1306158134
Name:SUNKARA, TAGORE (MD)
Entity type:Individual
Prefix:
First Name:TAGORE
Middle Name:
Last Name:SUNKARA
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 1:2500 HOSPITAL BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4946
Mailing Address - Country:US
Mailing Address - Phone:770-740-1753
Mailing Address - Fax:770-740-8503
Practice Address - Street 1:2500 HOSPITAL BLVD STE 130
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4946
Practice Address - Country:US
Practice Address - Phone:770-740-1753
Practice Address - Fax:770-740-8503
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272910207R00000X
IAMD-44517207R00000X, 207RG0100X
GA93506207RG0100X
SC89539207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine