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General NPI Number Information
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NPI Number | 1417571761
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Entity Type | Individual
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Provider Name | SAM K SUHAIL MD, EDD, MPH, MBA
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Gender | Male
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 7201 E 31ST PL
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City | YUMA
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State | AZ
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Zip | 85365-8394
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Country | US
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Telephone | 928-336-5660
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Fax | 928-336-5672
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Provider Business Mailing Address
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Address Line | 2400 S AVENUE A
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City | YUMA
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State | AZ
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Zip | 85364-7170
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Country | US
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Telephone | 928-344-2000
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 73802
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036168721
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License Number State | IL
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