Provider Demographics
NPI:1609891779
Name:SUNDHEIM, SUZANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:SUNDHEIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 WALNUT ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5751
Mailing Address - Country:US
Mailing Address - Phone:303-786-7430
Mailing Address - Fax:303-443-4682
Practice Address - Street 1:2501 WALNUT ST
Practice Address - Street 2:SUITE 106
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5751
Practice Address - Country:US
Practice Address - Phone:303-786-7430
Practice Address - Fax:303-443-4682
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO331342084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01-331347Medicaid
CO33134OtherCO LICENSE
CO33134OtherCO LICENSE
CO33134OtherCO LICENSE