Provider Demographics
NPI:1295761542
Name:SUMAN, AJAY (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:
Last Name:SUMAN
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 1:90 ALTON RD APT 409
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6878
Mailing Address - Country:US
Mailing Address - Phone:786-774-7143
Mailing Address - Fax:
Practice Address - Street 1:907 E REED ST
Practice Address - Street 2:
Practice Address - City:HAYTI
Practice Address - State:MO
Practice Address - Zip Code:63851-1242
Practice Address - Country:US
Practice Address - Phone:786-774-7143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6697207L00000X, 207LP2900X
MO2018033164207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology