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NPI Code Detail

MEDICARE: CLAY SUNDERMAN

MEDICARE: CLAY SUNDERMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12471C3402XRadiography Radiologic Technologist

General Provider Information

NPI Number : 1043142565
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAY SUNDERMAN
Provider Business Mailing Address
First Line : 11110 E 106TH ST
Second Line :
City : FISHERS
State : IN
Zip : 46037-3603
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-988-4370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ CLAY SUNDERMAN ” Practice Location

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