Provider Demographics
NPI:1043283674
Name:SUTER, MICHAEL DAVID (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:SUTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 HARFORD RD
Mailing Address - Street 2:STE E
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-9205
Mailing Address - Country:US
Mailing Address - Phone:410-665-4403
Mailing Address - Fax:410-661-5087
Practice Address - Street 1:8109 HARFORD RD
Practice Address - Street 2:STE E
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-9205
Practice Address - Country:US
Practice Address - Phone:410-665-4403
Practice Address - Fax:410-661-5087
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0044604207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD169041800Medicaid
MD169041800Medicaid
F62490Medicare UPIN