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General NPI Number Information
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NPI Number | 1487617593
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Entity Type | Individual
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Provider Name | MARK Y SUN MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 11850 BLACKFOOT ST NW STE 270
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City | COON RAPIDS
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State | MN
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Zip | 55433-2593
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Country | US
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Telephone | 651-312-1717
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Fax | 651-312-1570
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Provider Business Mailing Address
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Address Line | 2550 UNIVERSITY AVE W STE 110N
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City | SAINT PAUL
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State | MN
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Zip | 55114-8693
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Country | US
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Telephone | 651-312-1505
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Fax | 651-312-1570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 222062
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 53998
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License Number State | MN
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