Provider Demographics
NPI:1831154061
Name:SUNDAY, MICHAEL T (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:SUNDAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-1108
Mailing Address - Country:US
Mailing Address - Phone:231-627-5601
Mailing Address - Fax:231-627-1592
Practice Address - Street 1:748 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721
Practice Address - Country:US
Practice Address - Phone:231-627-5601
Practice Address - Fax:231-627-1592
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010349992085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2770325Medicaid
MIM72490015OtherMEDICARE
B45083Medicare UPIN