Individual
MARK SUNDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5880 S HOSPITAL DR, GLOBE, AZ 85501-9447
(469) 757-1120
Mailing address
PO BOX 53519, PHOENIX, AZ 85072-3519
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3290
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116317
MEDICARE
AZ
01
—
116318
MEDICARE
AZ
01
—
116319
MEDICARE
AZ
Enumeration date
05/09/2007
Last updated
08/27/2007
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