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Aditya Pandu Sunidja, MD
Diagnostic Radiology Physician in Tacoma, Washington
NPI 1861631459

Aditya Pandu Sunidja is a Diagnostic Radiology Physician based in Tacoma, WA and is specialized in Diagnostic Radiology. Aditya Pandu Sunidja practices in Tacoma, WA and has the professional credentials of MD. The NPI Number for Aditya Pandu Sunidja is 1861631459 and holds a License No. 235938 (Washington).

The current practice location address for Aditya Pandu Sunidja is 1304 Fawcett Ave, Tacoma, WA and can be reached out via phone at 253-761-4200 and via fax at 253-383-3553.

Location: 1304 Fawcett Ave, Tacoma, WA, 98401-1535
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Provider Profile Details
NPI Number
1861631459
Provider Name
Aditya Pandu Sunidja
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1304 Fawcett Ave, Tacoma, WA, 98401-1535
Phone Number
253-761-4200
Fax Number
253-383-3553
Provider Enumeration Date
02/05/2009
Last Update Date
09/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
G8882744 01 WA PTAN-TRA PIERCE CO
G8882901 01 WA PTAN-UAOM
R174972 01 WA PTAN-PENDLETON, OREGON
G8883121 01 WA PTAN-MIO1
0252135 01 WA LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
G8883319 01 WA PTAN-TRA KING CO
2001567 05 WA
institution
Provider Business Practice Location Address Details
Address
1304 Fawcett Ave
City
State
Zip
98402-1911
Phone Number
253-761-4200
Fax Number
253-383-3553
person
Provider Business Mailing Address Details
Address
1304 Fawcett Ave
City
State
Zip
98402-1911
Phone Number
253-761-4200
Fax Number
253-383-3553
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
MD60082442 (Washington)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
235938 (Massachusetts)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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