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General NPI Number Information
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NPI Number | 1952544199
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Entity Type | Individual
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Provider Name | THERESA SUOZZI MD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 2040 N SHADELAND AVE STE 250
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-1712
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Country | US
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Telephone | 317-355-5009
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E. 75TH STREET SUITE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 048872
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 45999
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 01072785A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01072785A
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License Number State | IN
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