Provider Demographics
NPI:1154360584
Name:SUNDERLAND, MARGARET CAROL (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:CAROL
Last Name:SUNDERLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NW ELKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3757
Mailing Address - Country:US
Mailing Address - Phone:541-768-4950
Mailing Address - Fax:541-768-4951
Practice Address - Street 1:501 NW ELKS DRIVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3757
Practice Address - Country:US
Practice Address - Phone:541-768-4950
Practice Address - Fax:541-768-4951
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5076207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134694209Medicaid
TX8R1562OtherBLUE CROSS OF TEXAS
TX134694208Medicaid
TX8A3662Medicare PIN
TX8R1562OtherBLUE CROSS OF TEXAS
TXE92363Medicare UPIN
TX830008691Medicare PIN