Healthcare Provider Details

I. General information

NPI: 1043283674
Provider Name (Legal Business Name): MICHAEL DAVID SUTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8109 HARFORD RD STE E
PARKVILLE MD
21234-9205
US

IV. Provider business mailing address

8109 HARFORD RD STE E
PARKVILLE MD
21234-9205
US

V. Phone/Fax

Practice location:
  • Phone: 410-665-4403
  • Fax: 410-661-5087
Mailing address:
  • Phone: 410-665-4403
  • Fax: 410-661-5087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0044604
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: