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Individual

ADAM M SUNDERLAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 DALLAS HWY STE 301, VILLA RICA, GA 30180
(770) 456-0211
Mailing address
150 CLINIC AVE STE 101, CARROLLTON, GA 30117-4402
(770) 834-0873

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
073845
GA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
073845
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003166316I
GA
05
003166316J
GA
05
003166316K
GA
Enumeration date
06/10/2010
Last updated
05/01/2019
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