David C Sundstrom, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

25MA05465900 Issued in NJ

Practice address

1680 State Route 23 Ste 250
Wayne, NJ 07470-7520

Phone

(973) 633-1122

Fax

(973) 832-7550

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1346246832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ROUTE 23",
            "address_2": "SUITE 250",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707501",
            "telephone_number": "973-633-1122",
            "fax_number": "973-633-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 STATE ROUTE 23 STE 250",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707520",
            "telephone_number": "973-633-1122",
            "fax_number": "973-832-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDSTROM",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA05465900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Medical Group PA
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• Sun Tao Studio L.L.C.
• Qiang Sun, MD
• Catherine Sundholm
• Jeffrey Sung, D.M.D.
• Sunrise Wayne Assisted Living LLC
• Sunshine Optical Inc.
• Sunshine Prosthetics and Orthotics
• Supreme Sleep LLC

• Neurological Surgery Physician in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Neurological Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.