Provider Demographics
NPI:1730468208
Name:VELAYUTHAN, SUJITHRA (MD)
Entity type:Individual
Prefix:
First Name:SUJITHRA
Middle Name:
Last Name:VELAYUTHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-844-9160
Mailing Address - Fax:216-844-2974
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-4433
Practice Address - Country:US
Practice Address - Phone:216-844-9160
Practice Address - Fax:216-844-2974
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH311310302080P0206X
NC460527330208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatrics