Provider Demographics
NPI:1174508584
Name:SUN, MARGARET A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:A
Last Name:SUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1445 WAMPANOAG TRAIL
Mailing Address - Street 2:UNITE 205
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02915
Mailing Address - Country:US
Mailing Address - Phone:401-434-0770
Mailing Address - Fax:401-633-6094
Practice Address - Street 1:1445 WAMPANOAG TRAIL
Practice Address - Street 2:UNITE 205
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02915
Practice Address - Country:US
Practice Address - Phone:401-434-0770
Practice Address - Fax:401-633-6094
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2010-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIRI8624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7004039Medicaid
F83844Medicare UPIN
RI007007193Medicare ID - Type Unspecified