Individual
SUZAN JARADAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 724-6124
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2020-0771
NM
390200000X
Student in an Organized Health Care Education/Training Program
RS2016-0953
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
11/13/2016
Last updated
01/21/2026
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