Healthcare Provider Details

I. General information

NPI: 1013824614
Provider Name (Legal Business Name): SUHR DALLAS MCINTYRE SUDPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12395 MCCRACKEN RD STE A-UP
GARFIELD HEIGHTS OH
44125-2967
US

IV. Provider business mailing address

27030 CEDAR RD APT 117
BEACHWOOD OH
44122-1137
US

V. Phone/Fax

Practice location:
  • Phone: 216-587-6827
  • Fax:
Mailing address:
  • Phone: 509-828-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: