Provider Demographics
NPI:1730171950
Name:SORTUR, AMARNATH G (MD)
Entity type:Individual
Prefix:
First Name:AMARNATH
Middle Name:G
Last Name:SORTUR
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 1:1601 MILLTOWN RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4027
Mailing Address - Country:US
Mailing Address - Phone:302-993-2330
Mailing Address - Fax:302-993-2344
Practice Address - Street 1:L6 OMEGA DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2077
Practice Address - Country:US
Practice Address - Phone:302-738-9300
Practice Address - Fax:302-738-3791
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072911L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001878450Medicaid
DE1000035975Medicaid
PA001878450Medicaid
DE138409ZDUTMedicare PIN
138409ZAS3Medicare PIN
DE138409ZDUQMedicare PIN
DE138409ZDURMedicare PIN
DE01710M01Medicare PIN
DE1000035975Medicaid
H54754Medicare UPIN
DE138409ZBXMMedicare PIN
DE138409ZDUSMedicare PIN
DE138409ZC7CMedicare PIN