Individual
THERESA KAY SUNDERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-7508
(704) 384-8666
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200300291
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891369F
—
NC
05
—
N0029B
—
SC
Enumeration date
05/02/2006
Last updated
11/03/2011
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