Provider Demographics
NPI:1316367121
Name:SUCHAK, SHANAYA (DO)
Entity Type:Individual
Prefix:
First Name:SHANAYA
Middle Name:
Last Name:SUCHAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N HIGLEY ROAD
Mailing Address - Street 2:ATTN: HOSPITALISTS
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-543-2034
Mailing Address - Fax:480-543-2647
Practice Address - Street 1:37000 N GANTZEL ROAD
Practice Address - Street 2:ATTN: HOSPITALISTS
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140
Practice Address - Country:US
Practice Address - Phone:480-543-2034
Practice Address - Fax:480-543-2647
Is Sole Proprietor?:No
Enumeration Date:2014-04-19
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007315207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine