Provider Demographics
NPI:1588907067
Name:SUNDLING, REBECCA ANN (DPM, MPH)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:SUNDLING
Suffix:
Gender:F
Credentials:DPM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2144 E PARIS AVE SE STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6117
Mailing Address - Country:US
Mailing Address - Phone:616-281-0666
Mailing Address - Fax:616-281-0752
Practice Address - Street 1:6050 NORTHLAND DR NE STE 180
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9258
Practice Address - Country:US
Practice Address - Phone:616-363-9833
Practice Address - Fax:616-363-9701
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5901002665213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty