Provider Demographics
NPI:1316972631
Name:SUD, ANUP (MD)
Entity type:Individual
Prefix:
First Name:ANUP
Middle Name:
Last Name:SUD
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:G3346 BEECHER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532
Mailing Address - Country:US
Mailing Address - Phone:810-733-2481
Mailing Address - Fax:810-733-2482
Practice Address - Street 1:G3346 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532
Practice Address - Country:US
Practice Address - Phone:810-733-2481
Practice Address - Fax:810-733-2482
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29909208G00000X
WI622208G00000X
IL036153856208G00000X
MI4301046199208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1805720 TYPE 10Medicaid
3302521291OtherBCBS
A75423Medicare UPIN
0M36940Medicare ID - Type Unspecified