Sunderland, Brent Anthony

Sunderland, Brent Anthony is an individual health care provider with primary practice located at 612 Mocksville Avenue , Charlotte NC 28144-2732. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Sunderland, Brent Anthony can be contacted via phone (704) 210-5061.

Contact Information

Primary practice address
612 Mocksville Avenue Charlotte NC 28144-2732
Phone: (704) 210-5061
Fax: (704) 210-5337
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 200201631 North Carolina
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 200201631 North Carolina

Profile Details

NPI number 1487626750
LBN Legal business name Sunderland, Brent Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Oct 20th, 2014 - about 12 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 1487626750 NPPES
North Carolina MEDICAID 89133CA
North Carolina MEDICAID N01632

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