Healthcare Provider Details

I. General information

NPI: 1578053898
Provider Name (Legal Business Name): VLADISLAV SUNTSOV DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 RESEARCH PKWY STE 205
COLORADO SPRINGS CO
80920-1093
US

IV. Provider business mailing address

2430 RESEARCH PKWY STE 205
COLORADO SPRINGS CO
80920-1093
US

V. Phone/Fax

Practice location:
  • Phone: 719-445-6242
  • Fax: 719-445-6332
Mailing address:
  • Phone: 719-445-6242
  • Fax: 719-445-6332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number009994
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberDR.0071399
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDR.0071399
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: