MEDICARE: DR. THOMAS ANDREW SUGDEN PSYD

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	103TC0700X	Clinical Psychologist	0810003305	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	279306	OTHER	ANTHEM PPO
3	279306	OTHER	BCBS
4	573544	OTHER	MAGELLAN
5	C01884	OTHER	MCARE GROUP #
6	279306	OTHER	ANTHEM HEALTHKEEPERS
7	085989M	OTHER	SENTARA OPTIMA
8	234201	OTHER	COMPSYCH
9	2114650	OTHER	MAMSI

General Provider Information

NPI Number	:	1598737496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ANDREW SUGDEN PSYD

Provider Business Mailing Address
First Line	:	3419 VIRGINIA BEACH BLVD # 800
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-4419
Country	:	US
Telephone Number	:	757-714-1838
Fax Number	:	757-321-6269

Provider Business Practice Location Address
First Line	:	228 N LYNNHAVEN RD STE 110
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7514
Country	:	US
Telephone Number	:	757-201-2927
Fax Number	:	757-321-6269

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	04/29/2013

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