Healthcare Provider Details

I. General information

NPI: 1831154061
Provider Name (Legal Business Name): MICHAEL T SUNDAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 SOUTH MAIN STREET
CHEBOYGAN MI
49721
US

IV. Provider business mailing address

PO BOX 1108
ANN ARBOR MI
48106-1108
US

V. Phone/Fax

Practice location:
  • Phone: 231-627-5601
  • Fax: 231-627-1592
Mailing address:
  • Phone: 231-627-5601
  • Fax: 231-627-1592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301034999
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: