# JOHN A SUNDIN MD ENDOSCOPY UNIT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** John A Sundin MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770728495
- **Authorized official:** JOHN A SUNDIN MD (OWNER)
- **Authorized official phone:** (336) 846-8939

## Contact information

- **Practice address:** 200 HOSPITAL AVE, SUITE 5, JEFFERSON, NC 28640-9244
- **Practice address phone:** (336) 846-8939
- **Practice address fax:** (336) 846-8370
- **Mailing address:** 200 HOSPITAL AVE, SUITE 5, JEFFERSON, NC 28640-9244
- **Mailing address phone:** (336) 846-8939
- **Mailing address fax:** (336) 846-8370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 200601912 | NC | Yes |

## Other

- **Enumeration date:** 12/09/2008
- **Last updated:** 12/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 56162 | MEDCOST | NC |