Provider Demographics
NPI:1801779541
Name:SUNDBY, JONATHAN MARK (MA)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:MARK
Last Name:SUNDBY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 PARAGON DR APT H
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6937
Mailing Address - Country:US
Mailing Address - Phone:651-808-1675
Mailing Address - Fax:
Practice Address - Street 1:10 E MONUMENT ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1018
Practice Address - Country:US
Practice Address - Phone:719-318-7459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program