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General NPI Number Information
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NPI Number | 1699169821
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Entity Type | Individual
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Provider Name | RAQUEL SUGINO DPM, MS
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Gender | Female
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 04/17/2020
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Provider Practice Location Address
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Address Line | 224 NE TUDOR RD
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5696
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Country | US
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Telephone | 816-525-4778
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Fax | 816-525-5761
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Provider Business Mailing Address
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Address Line | 224 NE TUDOR RD
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5696
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Country | US
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Telephone | 816-525-4778
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Fax | 816-525-5761
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5451
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License Number State | CA
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