MEDICARE: EDGAR ARTHUR SUTER 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
1	207Q00000X	Family Medicine Physician	28552	AZ
2	207U00000X	Nuclear Medicine Physician	28552	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1588637326	OTHER	AZ	MEDICARE-NPI

Other Identifiers

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

General Provider Information

NPI Number	:	1588637326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDGAR ARTHUR SUTER MD

Provider Business Mailing Address
First Line	:	4600 S MILL AVE
Second Line	:	280
City	:	TEMPE
State	:	AZ
Zip	:	85282-6757
Country	:	US
Telephone Number	:	480-305-2888
Fax Number	:	480-305-2889

Provider Business Practice Location Address
First Line	:	287 E HUNT HWY
Second Line	:	SUITE 105
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-5096
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-677-8283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	09/05/2014

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Directions to “ EDGAR ARTHUR SUTER MD” Practice Location

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