Provider Demographics
NPI:1588637326
Name:SUTER, EDGAR ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:ARTHUR
Last Name:SUTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 S MILL AVE
Mailing Address - Street 2:280
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-6757
Mailing Address - Country:US
Mailing Address - Phone:480-305-2888
Mailing Address - Fax:480-305-2889
Practice Address - Street 1:287 E HUNT HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-5096
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:480-677-8283
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ28552207Q00000X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1588637326OtherMEDICARE-NPI
AZ945454Medicaid
AZ1588637326OtherMEDICARE-NPI
A48884Medicare UPIN