Sundblad, Kyle Wayne

Sundblad, Kyle Wayne is an individual health care provider with primary practice located at 9001 15 Mile Rd Suite A, Sterling Heights MI 48312-3611. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Sundblad, Kyle Wayne can be contacted via phone (586) 979-0560.

Contact Information

Primary practice address
9001 15 Mile Rd Suite A Sterling Heights MI 48312-3611
Phone: (586) 979-0560
Fax: (586) 979-8766
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901002053 Michigan

Profile Details

NPI number 1205813797
LBN Legal business name Sundblad, Kyle Wayne
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205813797 NPPES
Other 0621950001 NPIN (DME)
Other 5501004 NPIN (DME)
MEDICAID 4522531 NPIN (DME)

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