Provider Demographics
NPI:1922396324
Name:SUKER, MANAR Y (MD)
Entity Type:Individual
Prefix:
First Name:MANAR
Middle Name:Y
Last Name:SUKER
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 1:6051 W 135TH STREET
Mailing Address - Street 2:SUITE F7
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-7901
Mailing Address - Country:US
Mailing Address - Phone:913-588-1227
Mailing Address - Fax:
Practice Address - Street 1:6501 W 135TH ST STE F7
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-7901
Practice Address - Country:US
Practice Address - Phone:913-588-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-40624207R00000X
IA41951207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS033D00186OtherWPS
KS201194850AMedicaid