Individual
BRENT A SUOZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8051 S EMERSON AVE STE 400, INDIANAPOLIS, IN 46237-8633
(317) 790-3355
(317) 790-3002
Mailing address
8051 S EMERSON AVE STE 400, INDIANAPOLIS, IN 46237-8633
(317) 790-3355
(317) 790-3002
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01072583A
IN
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
01072583A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01072583A
LICENSE
IN
05
—
201190860
—
IN
Enumeration date
10/07/2008
Last updated
05/10/2019
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