Provider Demographics
NPI:1477546323
Name:SUBER, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2501 E SOUTHERN AVE
Mailing Address - Street 2:# 17
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7669
Mailing Address - Country:US
Mailing Address - Phone:480-838-1000
Mailing Address - Fax:480-491-6894
Practice Address - Street 1:2501 E SOUTHERN AVE
Practice Address - Street 2:# 17
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7669
Practice Address - Country:US
Practice Address - Phone:480-838-1000
Practice Address - Fax:480-491-6894
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2012-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ116162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D00385Medicare UPIN
AZZ33642399SMedicare ID - Type Unspecified