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Individual

DR. PHILIP DEWAIN SUNDQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1030 N 7TH ST, CHARITON, IA 50049-1206
(641) 217-9115
Mailing address
1030 N 7TH ST, PO BOX 674, CHARITON, IA 50049-1206
(641) 217-9115

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
26013
AL
207Q00000X
Family Medicine Physician
Primary
37367
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6400210
IA
01
70228
WELLMARK
IA
Enumeration date
05/22/2007
Last updated
10/21/2010
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