Provider Demographics
NPI:1497830681
Name:SCHUDER, SUZIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZIE
Middle Name:E
Last Name:SCHUDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:901 DOVER DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5538
Mailing Address - Country:US
Mailing Address - Phone:949-722-9884
Mailing Address - Fax:949-722-9885
Practice Address - Street 1:901 DOVER DR
Practice Address - Street 2:SUITE 204
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5538
Practice Address - Country:US
Practice Address - Phone:949-722-9884
Practice Address - Fax:949-722-9885
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG 821712084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF36056Medicare UPIN