MEDICARE: DR. DAVID SUGERMAN 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	207P00000X	Emergency Medicine Physician	35061966S	OH

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	:	1851352090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SUGERMAN MD

Provider Business Mailing Address
First Line	:	4155 GILES RD
Second Line	:
City	:	MORELAND HLS
State	:	OH
Zip	:	44022-2028
Country	:	US
Telephone Number	:	440-247-7488
Fax Number	:

Provider Business Practice Location Address
First Line	:	7123 PEARL RD
Second Line	:	SUITE 201
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-4975
Country	:	US
Telephone Number	:	440-842-7990
Fax Number	:	440-842-8835

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	01/17/2014

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