Individual
DR. LISA V SUFFIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Mailing address
1 CHILDRENS PL, C B 8116, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
110860
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103810122
—
MO
Enumeration date
05/27/2006
Last updated
10/27/2015
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