Provider Demographics
NPI:1588657910
Name:SULIT, G ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:G
Middle Name:ANDREW
Last Name:SULIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 E BAYWOOD AVE
Mailing Address - Street 2:STE 401
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1749
Mailing Address - Country:US
Mailing Address - Phone:480-835-7111
Mailing Address - Fax:480-969-9345
Practice Address - Street 1:6750 E BAYWOOD AVE
Practice Address - Street 2:STE 401
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1749
Practice Address - Country:US
Practice Address - Phone:480-835-7111
Practice Address - Fax:480-969-9345
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ20912207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ127028Medicaid
F35884Medicare UPIN
AZ127028Medicaid