Healthcare Provider Details

I. General information

NPI: 1043471642
Provider Name (Legal Business Name): JENNIFER D SUNDAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 MAIN ST SUITE 9
NORWAY ME
04268-5647
US

IV. Provider business mailing address

193 MAIN ST
NORWAY ME
04268-5645
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-8766
  • Fax: 207-743-1579
Mailing address:
  • Phone: 207-743-8766
  • Fax: 207-553-8348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4437
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO2128
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: