Provider Demographics
NPI:1043247943
Name:SUN, WILLIAM Z (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:Z
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2031 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5611
Mailing Address - Country:US
Mailing Address - Phone:215-564-4277
Mailing Address - Fax:215-563-9721
Practice Address - Street 1:2031 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5611
Practice Address - Country:US
Practice Address - Phone:215-564-4277
Practice Address - Fax:215-563-9721
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-020214-E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA155826OtherAARP
PA2353OtherAETNA
PA0053211000OtherKEYSTONE
PA0810299Medicaid
PA155826OtherBLUE SHIELD
PA32044OtherHEALTH/SENIOR PARTNERS
PA0053211000OtherKEYSTONE
PA155826OtherBLUE SHIELD
PA0822920001Medicare NSC
PA155826Medicare PIN