Provider Demographics
NPI:1689822322
Name:SUDDOO, ANDREE GISELE E (PHD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREE
Middle Name:GISELE E
Last Name:SUDDOO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13004 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2959
Mailing Address - Country:US
Mailing Address - Phone:301-203-3765
Mailing Address - Fax:
Practice Address - Street 1:13004 MONROE AVE
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-2959
Practice Address - Country:US
Practice Address - Phone:301-203-3765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-07
Last Update Date:2008-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD629054175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath