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Individual
DR. SCOTT T SUNDE
Active
Individual
DR. SCOTT T SUNDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
79-285
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05679079
—
NM
01
—
8HM190
MEDICARE PTAN
NM
01
—
HSZ162
MEDICARE PART B
NM
01
—
HSZ196
MEDICARE PART B
NM
05
—
K3526
—
NM
05
—
S5549
—
NM
Enumeration date
06/22/2005
Last updated
12/15/2010
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