Provider Demographics
NPI:1609307792
Name:SUNDET, ALEC (MD)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:SUNDET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 W RIO SALADO PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2892
Mailing Address - Country:US
Mailing Address - Phone:480-962-0071
Mailing Address - Fax:
Practice Address - Street 1:1255 W RIO SALADO PKWY STE 107
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2892
Practice Address - Country:US
Practice Address - Phone:480-962-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ69525207XS0117X
MN71161207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine