Provider Demographics
NPI:1386861235
Name:BUXTON, SUZAN SAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZAN
Middle Name:SAM
Last Name:BUXTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6622 N 91ST AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2569
Mailing Address - Country:US
Mailing Address - Phone:602-759-6883
Mailing Address - Fax:602-224-3358
Practice Address - Street 1:10615 W THUNDERBIRD BLVD STE C100
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3097
Practice Address - Country:US
Practice Address - Phone:623-974-1763
Practice Address - Fax:623-972-2038
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2019-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDP18466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ421436Medicaid
AZ129382Medicare PIN