Individual
THERESA SUOZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2040 N SHADELAND AVE STE 250, INDIANAPOLIS, IN 46219-1712
(317) 355-5009
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01072785A
IN
207Q00000X
Family Medicine Physician
048872
CT
207Q00000X
Family Medicine Physician
45999
CO
207QA0401X
Addiction Medicine (Family Medicine) Physician
01072785A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236346
—
CT
05
—
201202360
—
IN
01
—
P01347744
RAILROAD MEDICARE
IN
Enumeration date
04/17/2009
Last updated
11/27/2023
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