Sunderland, Theresa Kay

Sunderland, Theresa Kay is an individual health care provider with primary practice located at 200 Hawthorne Ln , Charlotte NC 28204-2515. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Sunderland, Theresa Kay can be contacted via phone (704) 384-7508.

Contact Information

Primary practice address
200 Hawthorne Ln Charlotte NC 28204-2515
Fax: (704) 384-8666
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 200300291 North Carolina

Profile Details

NPI number 1487612107
LBN Legal business name Sunderland, Theresa Kay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated Nov 3rd, 2011 - about 15 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 1487612107 NPPES
South Carolina MEDICAID N0029B
South Carolina MEDICAID 891369F

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