Maxim Sungurov

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

2016-02365 Issued in NC

Practice address

2001 Vail Ave
Charlotte, NC 28207-1248

Phone

(704) 304-6070

NPI assigned

Sep 26, 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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msungurov417367@direct.medicine.duke.edu

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

• Cooper Physician Offices, PA

  • Internal Medicine Physician
  • Camden, NJ
  • NPI 1154369510

  Hospitalist

  Medicare reassignment NPD

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1952397812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071248",
            "telephone_number": "704-304-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNGUROV",
        "first_name": "MAXIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2016-02365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicja Erazo Sundblade, FNP-C
• Brent Anthony Sunderland, MD
• Theresa Kay Sunderland, MD
• Sunflower Speech & Myo Therapy, PLLC
• Sunflower Therapeutic Solutions, PLLC
• Samhita Sunkara
• Sunpath LLC
• Sunrise ABA of North Carolina LLC
• Sunrise Adult and Youth Services Inc
• Sunrise Eastover Assisted Living, LLC

• Hospitalist Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Hospitalist Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.