Healthcare Provider Details

I. General information

NPI: 1407891559
Provider Name (Legal Business Name): BENJAMIN M. SUCHER, D.O., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10585 N TATUM BLVD SUITE D135
PARADISE VALLEY AZ
85253-1073
US

IV. Provider business mailing address

10585 N TATUM BLVD SUITE D135
PARADISE VALLEY AZ
85253-1073
US

V. Phone/Fax

Practice location:
  • Phone: 480-483-7387
  • Fax: 480-483-3684
Mailing address:
  • Phone: 480-483-7387
  • Fax: 480-483-3684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number1525
License Number StateAZ

VIII. Authorized Official

Name: DR. BENJAMIN M SUCHER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 480-483-7387