Michael Robert Sunderman Sr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

24534 Issued in NC

Practice address

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237

Phone

(252) 962-3340

Fax

(252) 962-3320

NPI assigned

Mar 23, 2006

Last updated

Dec 4, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boice-Willis Clinic, PA

  • Physical Therapy Clinic/Center
  • Rocky Mount, NC
  • NPI 1952557241
  NPD (past)
• DLP Wilson Physician Practices LLC

  • Family Medicine Physician
  • Wilson, NC
  • NPI 1932521010
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1649230913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "252-962-3340",
            "fax_number": "252-962-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "252-962-3340",
            "fax_number": "252-962-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERMAN",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "24534",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "24534",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8980996",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci W. Suber, PHARM.D.
• Jeffrey M Suchniak, MD
• Chanee Sullivan, RNC, BSN, IBCLC
• Cristina Boston Summers, PA-C
• Summit Home Healthcare, Inc.
• Support Staff Inc
• Support Staff, Inc
• Surecare Homecare
• Ellery Swain, DNP, CRNA
• Lauren Williams Swarr, DNP

• Specialist in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.