Healthcare Provider Details

I. General information

NPI: 1548468002
Provider Name (Legal Business Name): SUNSTRUM MEDICAL ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 MONROE ST
DEARBORN MI
48124-2917
US

IV. Provider business mailing address

1934 MONROE ST
DEARBORN MI
48124-2917
US

V. Phone/Fax

Practice location:
  • Phone: 313-565-7464
  • Fax: 313-565-3620
Mailing address:
  • Phone: 313-565-7464
  • Fax: 313-565-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES CAMERON SUNSTRUM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 313-565-7464