MEDICARE: G ANDREW SULIT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	20912	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588657910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	G ANDREW SULIT MD

Provider Business Mailing Address
First Line	:	6750 E BAYWOOD AVE
Second Line	:	STE 401
City	:	MESA
State	:	AZ
Zip	:	85206-1749
Country	:	US
Telephone Number	:	480-835-7111
Fax Number	:	480-969-9345

Provider Business Practice Location Address
First Line	:	6750 E BAYWOOD AVE
Second Line	:	STE 401
City	:	MESA
State	:	AZ
Zip	:	85206-1749
Country	:	US
Telephone Number	:	480-835-7111
Fax Number	:	480-969-9345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	05/19/2021

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Directions to “ G ANDREW SULIT MD” Practice Location

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