Provider Demographics
NPI:1912977083
Name:SUNDBY, KAREN JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JOY
Last Name:SUNDBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:JOY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4700 HALE PKWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4050
Mailing Address - Country:US
Mailing Address - Phone:303-388-8807
Mailing Address - Fax:303-962-0329
Practice Address - Street 1:4700 HALE PKWY
Practice Address - Street 2:SUITE 140
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4050
Practice Address - Country:US
Practice Address - Phone:303-388-8807
Practice Address - Fax:303-962-0329
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41658207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00332354OtherRR PTAN
COP00332354OtherRR PTAN
COI33509Medicare UPIN