Healthcare Provider Details

I. General information

NPI: 1699301325
Provider Name (Legal Business Name): SUMA ANCHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 TOWNSHIP LINE RD
ELKINS PARK PA
19027-2220
US

IV. Provider business mailing address

60 TOWNSHIP LINE RD
ELKINS PARK PA
19027-2220
US

V. Phone/Fax

Practice location:
  • Phone: 215-663-6677
  • Fax: 215-663-6265
Mailing address:
  • Phone: 215-663-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL.0011075
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2021023158
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD496064
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: