Provider Demographics
NPI:1851352090
Name:SUGERMAN, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SUGERMAN
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 1:4155 GILES RD
Mailing Address - Street 2:
Mailing Address - City:MORELAND HLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2028
Mailing Address - Country:US
Mailing Address - Phone:440-247-7488
Mailing Address - Fax:
Practice Address - Street 1:7123 PEARL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4975
Practice Address - Country:US
Practice Address - Phone:440-842-7990
Practice Address - Fax:440-842-8835
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061966S207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0882808Medicaid
OH0892452Medicare ID - Type Unspecified
OH0882808Medicaid