Individual
MARK SUNDELL
Active
Individual
MARK SUNDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
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
Update your record
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