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Individual

MR. CHAD ERIC SUNDQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1416 E A ST, SUITE 101, CASPER, WY 82601-2276
(307) 577-8600
(307) 577-8605
Mailing address
1416 E A ST, SUITE 101, CASPER, WY 82601-2276
(307) 577-8600
(307) 577-8605

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TL398
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00611278
MEDICARE RAILROAD
Enumeration date
10/17/2006
Last updated
02/10/2016
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