Healthcare Provider Details

I. General information

NPI: 1952490229
Provider Name (Legal Business Name): HEIDI LYNN SUN DAVIS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI LYNN SUN VENTLINE DO

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE
TOLEDO OH
43614-2595
US

IV. Provider business mailing address

3000 ARLINGTON AVE STOP 1108
TOLEDO OH
43614-2595
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-3556
  • Fax: 419-383-3550
Mailing address:
  • Phone: 419-383-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number5101025031
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34.018683
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: