Provider Demographics
NPI:1043743958
Name:SENDAK, MYA DEBOER (MD)
Entity Type:Individual
Prefix:
First Name:MYA
Middle Name:DEBOER
Last Name:SENDAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYA
Other - Middle Name:DEBOER
Other - Last Name:SENDOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:214 HUNT ST APT 306
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4884
Mailing Address - Country:US
Mailing Address - Phone:510-209-0181
Mailing Address - Fax:
Practice Address - Street 1:2609 N DUKE ST STE 1000
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-3048
Practice Address - Country:US
Practice Address - Phone:919-220-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-03632208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics