Basic Information
Provider Information
NPI: 1134535560
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARORA
FirstName: SUMANT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 421
Address2:  
City: LIBERTY LAKE
State: WA
PostalCode: 990190421
CountryCode: US
TelephoneNumber: 5094892600
FaxNumber: 5092277070
Practice Location
Address1: 212 E CENTRAL AVE STE 245
Address2:  
City: SPOKANE
State: WA
PostalCode: 992086289
CountryCode: US
TelephoneNumber: 5094892600
FaxNumber: 5092277070
Other Information
ProviderEnumerationDate: 07/07/2014
LastUpdateDate: 04/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000XR-10771IAN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RG0100XMD61002980WAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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