Healthcare Provider Details

I. General information

NPI: 1992976310
Provider Name (Legal Business Name): SARAH E SUDDUTH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH E PIATT M.D.

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 NE RALPH POWELL RD
LEES SUMMIT MO
64064-2361
US

IV. Provider business mailing address

2310 HOLMES ST STE 800
KANSAS CITY MO
64108-2602
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-2170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2011009923
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: