Provider Demographics
NPI:1124178876
Name:SUGGS, ADRIENNE H (MD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:H
Last Name:SUGGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11265 RIDERMARK ROW
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5701
Mailing Address - Country:US
Mailing Address - Phone:443-777-6145
Mailing Address - Fax:443-777-7130
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:DEPT OF PEDIATRICS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-6145
Practice Address - Fax:443-777-7139
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00532202080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD75859901OtherBLUE SHIELD
MDG23185Medicare UPIN
MD761LI289Medicare PIN