Provider Demographics
NPI:1518225861
Name:SUNGAR, WILLIAM GANNON (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GANNON
Last Name:SUNGAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:GANNON
Other - Middle Name:WILLIAM
Other - Last Name:SUNGAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:758 S LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4126
Mailing Address - Country:US
Mailing Address - Phone:925-330-7622
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:MAIL CODE #0108
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-7142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0056701207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine