Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 43281 | CO |
NPI | 1023093440 |
---|---|
Provider Name | Dr. Matthew David Suskin |
First Address | Denver, CO 80205-5422 |
Second Address | Denver, CO 80205-5422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 31/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018151 | KAISER COMMERCIAL NUMBER (01) | CO |
86539019 | (05) | CO |
I24803 | (02) |