Provider Demographics
NPI:1083828610
Name:SUMPTER, STEVEN RUSH (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RUSH
Last Name:SUMPTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:10815 W MCDOWELL RD
Practice Address - Street 2:201
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5007
Practice Address - Country:US
Practice Address - Phone:602-433-0155
Practice Address - Fax:623-433-0185
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2019-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016961207Q00000X
AZ005287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ447025Medicaid
AZ447025Medicaid