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General NPI Number Information
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NPI Number | 1508857962
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Entity Type | Individual
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Provider Name | MICHAEL JOHN SUNDBORG M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 145 APPLECROSS RD
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City | SOUTHERN PINES
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State | NC
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Zip | 28388-0749
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Country | US
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Telephone | 910-692-7928
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Fax | 910-692-5962
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Provider Business Mailing Address
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Address Line | 145 APPLECROSS RD
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City | SOUTHERN PINES
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State | NC
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Zip | 28388-0749
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Country | US
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Telephone | 910-692-7928
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Fax | 910-692-5962
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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 | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 2009-00486
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License Number State | NC
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