Sundman, Michael Richard
Sundman, Michael Richard is an sole proprietor health care provider with primary practice located at 1400 Farmington Ave Walmart Vision Center, Bristol CT 06010-4701. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sundman, Michael Richard can be contacted via phone (860) 585-1156.Contact Information
Primary practice address
1400 Farmington Ave Walmart Vision Center
Bristol CT 06010-4701
Phone: (860) 585-1156
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 002398 | Connecticut |
Profile Details
| NPI number | 1063595783 |
|---|---|
| LBN Legal business name | Sundman, Michael Richard |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2006 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063595783 | NPPES |
| Connecticut | Other | 020398 | CONNECTICARE |
| Connecticut | Other | 090002398CT02 | CONNECTICARE |
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