Healthcare Provider Details

I. General information

NPI: 1063410496
Provider Name (Legal Business Name): WILLIAM A SUAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1089 PRAY BLVD
WATERVILLE OH
43566-8712
US

IV. Provider business mailing address

4510 DORR ST # MS 840
TOLEDO OH
43615-4040
US

V. Phone/Fax

Practice location:
  • Phone: 567-952-2100
  • Fax: 567-952-2101
Mailing address:
  • Phone: 567-952-2100
  • Fax: 567-952-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number35066613
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: