Provider Demographics
NPI:1639281942
Name:SUASIN, WINLOVE B (MD)
Entity Type:Individual
Prefix:
First Name:WINLOVE
Middle Name:B
Last Name:SUASIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 S HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GLOBE
Mailing Address - State:AZ
Mailing Address - Zip Code:85501-9447
Mailing Address - Country:US
Mailing Address - Phone:928-425-3261
Mailing Address - Fax:928-425-7903
Practice Address - Street 1:2224 W NORTHERN AVE STE D300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5099
Practice Address - Country:US
Practice Address - Phone:602-277-1449
Practice Address - Fax:602-277-9984
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD - 111382085R0001X
CAA509962085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH52711OtherMEDICARE INDIVIDUAL PIN
CA00A509960Medicare PIN
F93171Medicare UPIN