Shetty, Sunderam Kodman

Shetty, Sunderam Kodman is an sole proprietor health care provider with primary practice located at 901 45Th St Kaplan Cancer Center, St Marys Hospital, West Palm Beach FL 33407-2413. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Shetty, Sunderam Kodman can be contacted via phone (561) 881-2815.

Contact Information

Primary practice address
901 45Th St Kaplan Cancer Center, St Marys Hospital West Palm Beach FL 33407-2413
Phone: (561) 881-2815
Fax: (561) 881-0951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME37893 Florida

Profile Details

NPI number 1720061674
LBN Legal business name Shetty, Sunderam Kodman
Credentials M.D., F.A.C.R.O.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 23rd, 2005
Last updated Jun 28th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720061674 NPPES
Florida MEDICAID 061721100

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