Individual
DR. BRIAN SCOTT SUCHARETZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 PARK PLACE, SUITE 200, MISHAWAKA, IN 46545-3566
(574) 607-4724
(574) 607-4725
Mailing address
515 PARK PLACE, SUITE 200, MISHAWAKA, IN 46545-3566
(574) 607-4724
(574) 607-4725
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01042730A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100462420A
—
IN
Enumeration date
07/22/2005
Last updated
03/17/2016
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