Individual
KYLE WAYNE SUNDBLAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9001 15 MILE RD, SUITE A, STERLING HEIGHTS, MI 48312-3611
(586) 979-0560
(586) 979-8766
Mailing address
9001 15 MILE RD, SUITE A, STERLING HEIGHTS, MI 48312-3611
(586) 979-0560
(586) 979-8766
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901002053
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0621950001
NPIN (DME)
—
05
—
4522531
—
MI
01
—
5501004
BCBS
MI
Enumeration date
12/27/2005
Last updated
07/08/2007
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