Provider Demographics
NPI:1366045429
Name:SUNDERLAND, DANIEL BRUCE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRUCE
Last Name:SUNDERLAND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 N BELT HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-1554
Mailing Address - Country:US
Mailing Address - Phone:816-233-3801
Mailing Address - Fax:816-912-3711
Practice Address - Street 1:3320 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-1554
Practice Address - Country:US
Practice Address - Phone:816-233-3801
Practice Address - Fax:816-912-3711
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016034001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist