Provider Demographics
NPI:1275536971
Name:SUAN, ERIC PINN (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:PINN
Last Name:SUAN
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 1:6115 FALLS RD
Mailing Address - Street 2:STE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2219
Mailing Address - Country:US
Mailing Address - Phone:410-377-7611
Mailing Address - Fax:410-377-8221
Practice Address - Street 1:6115 FALLS RD
Practice Address - Street 2:STE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2219
Practice Address - Country:US
Practice Address - Phone:410-377-7611
Practice Address - Fax:410-377-8221
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051444207W00000X
PAMD-039313-E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4368007009OtherCIGNA
MD452783OtherMDIPA
PA01122501OtherCAPITAL BLUE CROSS
PA1521347OtherGATEWAY
0800581OtherAMERICHOICE
MD352783OtherMAMSI
MD215480300Medicaid
PA680084OtherHIGHMARK BLUE SHIELD
PA125529907Medicaid
MD911736OtherBLOCK VISION
MD54609505OtherCAREFIRST BC/BS
803254OtherAETNA
MDR6160001OtherCAREFIRST BLUE CROSS
PA125529907Medicaid
MDR6160001OtherCAREFIRST BLUE CROSS
MD54609505OtherCAREFIRST BC/BS
4368007009OtherCIGNA
E92680Medicare UPIN