Sunderlin, Keith B

Sunderlin, Keith B is an individual health care provider with primary practice located at 593 Eddy St Apc 4, Providence RI 02903-4923. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Sunderlin, Keith B can be contacted via phone (401) 444-4000.

Contact Information

Primary practice address
593 Eddy St Apc 4 Providence RI 02903-4923
Phone: (401) 444-4000
Fax: (401) 444-6681
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 102283 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00417 Rhode Island

Profile Details

NPI number 1093707655
LBN Legal business name Sunderlin, Keith B
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Oct 22nd, 2010 - 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 1093707655 NPPES
Rhode Island MEDICAID 9005145

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