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Individual

JON R SUNDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8TH AVENUE AND C STREET, LDS HOSPITAL, SALT LAKE CITY, UT 84143
(801) 507-5248
(801) 733-5618
Mailing address
3340 NORTH CENTER ST, #800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85-173234-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002088710
NV
05
101832900
WY
01
107006550101
IHC
UT
01
13720
DESERET MUTUAL
UT
01
1502954
UMWA
UT
01
2090168
UNITED HEALTHCARE
UT
05
246092
AZ
01
37824
PEHP
UT
01
53274
HEALTHY U
UT
05
804075900
ID
01
8597445
WORKERS COMP FUND
UT
01
870545614SN1
EDUCATORS MUTUAL
UT
01
QM0000075886
ALTIUS
UT
01
TPRA08820
MOLINA
UT
Enumeration date
07/31/2006
Last updated
10/15/2012
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