| Doctor Name: | DR. PREETH KADA SUNDARAN |
| NPI Number: | 1043523186 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 060-0003891 |
| Business Practice Address: | 130 Fisher Rd Mob-a Suite 1-2 Barre, VT - 056419004 |
| Business Phone Number: | 8022255660 |
| Business Fax Number: | 8022299533 |
| Mailing Address: | Po Box 547, Attention: Cvmc Billing Department BARRE |
| State: | VT |
| Postal Code: | 056410547 |
| Phone Number: | 8022255660 |
| Fax Number: | 8022299533 |
| NPI Enumeration Date: | 07/19/2010 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 060-0003891 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |