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General NPI Number Information
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NPI Number | 1679718209
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Entity Type | Individual
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Provider Name | TARIQ SUWAN MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 9040 QUIVIRA RD
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City | LENEXA
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State | KS
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Zip | 66215-3902
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Country | US
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Telephone | 816-281-5407
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Fax |
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Provider Business Mailing Address
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Address Line | 4405 W 150TH ST
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City | LEAWOOD
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State | KS
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Zip | 66224-9547
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Country | US
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Telephone | 313-920-4957
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301088378
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 2020038097
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License Number State | MO
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