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Individual

DR. MICHAEL RICHARD SUNDMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1400 FARMINGTON AVE, WALMART VISION CENTER, BRISTOL, CT 06010-4701
(860) 585-1156
Mailing address
382 GILLETTE RD, NEW HARTFORD, CT 06057-2809
(860) 496-1922

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002398
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020398
CONNECTICARE
CT
01
090002398CT02
ANTHEM BC/BS
CT
Enumeration date
10/24/2006
Last updated
07/08/2007
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