Provider Demographics
NPI:1144217829
Name:BURNS, SUZANNE (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:900 WARREN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1430
Practice Address - Country:US
Practice Address - Phone:401-331-1221
Practice Address - Fax:401-751-8003
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07297207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI709004159OtherMEDICARE GROUP
RI110197572OtherRAILROAD MEDICARE
RI202185OtherBLUE CHIP
RI050483739OtherGREAT WEST HEALTH CARE
RI20059OtherBCBS OF RI
RI404464OtherTUFTS HEALTH PLAN
RI60777OtherHARVARD HEALTH PLAN
RI710025501OtherCIGNA
RISB18499Medicaid
RI04-00439OtherUNITED HEALTH CARE
RI20849OtherNEIGHBORHOOD HEALTH PLAN
RISB18499Medicaid
RI202185OtherBLUE CHIP
RI007057724Medicare ID - Type Unspecified