Provider Demographics
NPI:1760801666
Name:SUNDLING, AMANDA JEAN (DO)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:SUNDLING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JEAN
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:19550 E 39TH ST S STE 300
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2306
Mailing Address - Country:US
Mailing Address - Phone:816-478-0220
Mailing Address - Fax:816-795-3456
Practice Address - Street 1:19550 E 39TH ST S STE 300
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2306
Practice Address - Country:US
Practice Address - Phone:816-478-0220
Practice Address - Fax:816-795-3456
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
MO2018005677207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program