Provider Demographics
NPI:1003865023
Name:SUN, JOHN H (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9397 CROWN CREST BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8575
Mailing Address - Country:US
Mailing Address - Phone:303-320-0699
Mailing Address - Fax:303-320-0897
Practice Address - Street 1:9397 CROWN CREST BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8575
Practice Address - Country:US
Practice Address - Phone:303-320-0699
Practice Address - Fax:303-320-0897
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35479208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO280000886OtherRAILROAD MEDICARE PIN
COC1354794Medicaid
G30606Medicare UPIN
COC88061Medicare ID - Type Unspecified
COCO40922Medicare PIN