Healthcare Provider Details

I. General information

NPI: 1811986110
Provider Name (Legal Business Name): SIMONA SUCHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIMONA FIALOVA

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ARCH ST STE G2
AKRON OH
44304-1430
US

IV. Provider business mailing address

75 ARCH ST STE G2
AKRON OH
44304-1430
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-4100
  • Fax: 330-375-4097
Mailing address:
  • Phone: 330-375-4100
  • Fax: 330-375-4097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number015581
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35095988
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: