Provider Demographics
NPI:1518185313
Name:SUN, WILLIAM W (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:SUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 ROSWELL RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3715
Mailing Address - Country:US
Mailing Address - Phone:404-252-4566
Mailing Address - Fax:404-252-4689
Practice Address - Street 1:4161 ROSWELL RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3715
Practice Address - Country:US
Practice Address - Phone:404-252-4566
Practice Address - Fax:404-252-4689
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5600111N00000X
CA20810111N00000X
CO3308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU20981Medicare ID - Type Unspecified