Individual
DR. DAVID LLOYD SUDDUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
480 OSBORNE RD NE STE AND200, FRIDLEY, MN 55432-2773
(763) 236-3800
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
32991
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012793
PREFERRED ONE
—
01
—
108461
UCARE
—
01
—
1507725
UBH
—
01
—
259466
PRONET
—
01
—
260032841
RR MEDICARE
—
05
—
275207700
—
MN
01
—
33A45SU
BCBS
—
01
—
596821
ARAZ
—
Enumeration date
01/25/2006
Last updated
02/14/2019
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