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1689806846

NPI Code Detail

MEDICARE: DR. KUSHAK SUCHDEV MD

MEDICARE: DR. KUSHAK SUCHDEV 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	2084N0400X	Neurology Physician	277246	MA
2	2084N0600X	Clinical Neurophysiology Physician	4301094559	MI
3	2084A2900X	Neurocritical Care Physician	35.149827	OH
4	2084N0400X	Neurology Physician	35.149827	OH
5	2084N0400X	Neurology Physician	4301094559	MI

General Provider Information

NPI Number	:	1689806846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KUSHAK SUCHDEV MD

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3555 OLENTANGY RIVER RD STE 2002
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3910
Country	:	US
Telephone Number	:	614-533-5500
Fax Number	:	614-533-0103

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

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	02/20/2025

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Directions to “ DR. KUSHAK SUCHDEV MD” Practice Location

Language	Start Address	Practice Location

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