Individual
MARC IRA SUFFIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
Mailing address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD00019185
WA
2083X0100X
Occupational Medicine Physician
Primary
MD00019185
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073121
—
WA
01
—
107658
LABOR & INDUSTRIES
WA
01
—
182213
LABOR & INDUSTRIES
WA
01
—
4292890
AETNA
—
01
—
8927126
CRIME VICTIMS COMP
WA
01
—
SU9526
REGENCE BLUE SHIELD
—
Enumeration date
06/22/2006
Last updated
03/07/2023
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