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NPI Code Detail

MEDICARE: KERRI H SUISSA MD

MEDICARE: KERRI H SUISSA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianD0060777MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19959OTHERCAREFIRST
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417946112
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRI H SUISSA MD
Provider Business Mailing Address
First Line : 20010 CENTURY BLVD
Second Line : SUITE 200
City : GERMANTOWN
State : MD
Zip : 20874-1115
Country : US
Telephone Number : 240-686-2300
Fax Number : 240-686-2330
Provider Business Practice Location Address
First Line : 18101 PRINCE PHILIP DR
Second Line :
City : OLNEY
State : MD
Zip : 20832-1514
Country : US
Telephone Number : 301-774-8900
Fax Number : 301-570-8574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 05/06/2010

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Directions to “ KERRI H SUISSA MD” Practice Location

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