| Name: | Cardinal Medical Group LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Jan 2010 (15 years ago) (Companies founded in January 2010) |
| Entity Number: | 000-442-345 |
| Register Number: | 000442345 |
| Historical Names: |
Sunitha Anne Ghanta, MD, LLC
|
| Place of Formation: | Madison County |
| Registered Office Street Address: | 185 WHITESPORT DR SW SUITE 1HUNTSVILLE, AL 35801-6487 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457654840 | 2010-12-07 | 2022-07-27 | 185 WHITESPORT DR SW STE 1, HUNTSVILLE, AL, 358016487, US | 185 WHITESPORT DR SW STE 1, HUNTSVILLE, AL, 358016487, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 256-213-1031 |
| Fax | 8007651229 |
Authorized person
| Name | DR. SUNITHA A GHANTA |
| Role | MD/OWNER |
| Phone | 2562131031 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 29794 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GHANTA, SUNITHA ANNE | Member |
| Name | Role |
|---|---|
| GHANTA, SUNITHA ANNE | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2022-01-14 | Name Change | Sunitha Anne Ghanta, MD, LLC | Cardinal Medical Group LLC |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
