Provider Demographics
NPI:1356554539
Name:FINK BRYAN, SUZETTE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:
Last Name:FINK BRYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUZETTE
Other - Middle Name:
Other - Last Name:FINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:28416 N 52ND PL
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3419
Mailing Address - Country:US
Mailing Address - Phone:402-671-8300
Mailing Address - Fax:
Practice Address - Street 1:28416 N 52ND PL
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3419
Practice Address - Country:US
Practice Address - Phone:402-671-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25734207P00000X
ORMD1712972085R0202X
NC2009-01236207P00000X
AZ520302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470376604-12Medicaid
IA1356554539Medicaid
NE096573031Medicare PIN
NE470376604-12Medicaid
AZZ189280Medicare PIN