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General NPI Number Information
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NPI Number | 1265453179
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Entity Type | Individual
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Provider Name | CARLOS ALBERTO SUESCUN JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 10900 N SCOTTSDALE ROAD SUITE 603
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-5216
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Country | US
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Telephone | 480-607-3800
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Fax | 480-607-3808
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Provider Business Mailing Address
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Address Line | 11000 N SCOTTSDALE RD STE 130
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6169
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Country | US
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Telephone | 480-626-1314
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Fax | 480-993-2306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35723
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License Number State | AZ
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