Provider Demographics
NPI:1740318500
Name:SUND, SHEILA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:LYNN
Last Name:SUND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-4007
Mailing Address - Country:US
Mailing Address - Phone:503-588-3600
Mailing Address - Fax:503-363-3891
Practice Address - Street 1:1015 3RD ST NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4007
Practice Address - Country:US
Practice Address - Phone:503-588-3600
Practice Address - Fax:503-363-3891
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD 162132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
EO4652Medicare UPIN