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1902890767

NPI Code Detail

MEDICARE: LORETO SULIT MD

MEDICARE: LORETO SULIT 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	207RP1001X	Pulmonary Disease Physician	34253	AZ
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	34253	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1902890767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORETO SULIT MD

Provider Business Mailing Address
First Line	:	PO BOX 33269
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85067-3269
Country	:	US
Telephone Number	:	602-406-4786
Fax Number	:	916-636-4358

Provider Business Practice Location Address
First Line	:	1955 W FRYE RD
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6282
Country	:	US
Telephone Number	:	480-909-3870
Fax Number	:	602-230-6462

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	12/16/2024

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Directions to “ LORETO SULIT MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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