Provider Information for 1306473814
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JOHN DAVID SUNDEEN MA
Sex: Male
NPI: 1306473814
Last Updated: 2023-08-16
Certification Date: 2023-05-24
Certification Date: 2023-05-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1306473814 | ||||||||
| Enumeration Date | 2020-03-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3734 HILLSIDE RD KETCHIKAN, AK 99901-5517 United States Phone: 907-821-4674 | Fax: | ||||||||
| Primary Practice Address | 3734 HILLSIDE RD KETCHIKAN, AK 99901-5517 United States Phone: 907-821-4674 | Fax: | ||||||||
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