Healthcare Provider Details

I. General information

NPI: 1700907193
Provider Name (Legal Business Name): ERIN R SUYDAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE STE 261
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

320 E NORTH AVE STE 261
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-6466
  • Fax: 412-359-8639
Mailing address:
  • Phone: 412-359-6466
  • Fax: 412-359-8639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD442293
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: