Provider Demographics
NPI:1730495201
Name:DUBE, SUTAPA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUTAPA
Middle Name:
Last Name:DUBE
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 1:4729 E SUNRISE DR # 246
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4534
Mailing Address - Country:US
Mailing Address - Phone:520-222-7811
Mailing Address - Fax:
Practice Address - Street 1:1120 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7408
Practice Address - Country:US
Practice Address - Phone:520-881-1292
Practice Address - Fax:520-818-1648
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52944202D00000X, 2084F0202X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry