Individual
SUETTA TENNEY
Active
Individual
SUETTA TENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71345
MA
207R00000X
Internal Medicine Physician
Primary
MD22576
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701800
BC BS ANTHEM
—
01
—
110229385
RAILROAD MEDICARE
—
05
—
3002764
—
MA
01
—
4978
FALLON
—
01
—
69626
HARVARD PILGRAM
—
01
—
712914
TUETS HEALTH PLAN
—
01
—
71345
MASS LICENSE #
—
Enumeration date
11/28/2006
Last updated
03/07/2023
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