Individual
NICOLE ANN SUGUMARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7332 E BUTHERUS DR HNGR 1, SCOTTSDALE, AZ 85260-8005
(602) 406-3000
Mailing address
17667 N 97TH ST, SCOTTSDALE, AZ 85255-2634
(480) 371-0114
(480) 371-0114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4991
AZ
363A00000X
Physician Assistant
55672
CA
363AM0700X
Medical Physician Assistant
4991
AZ
363AM0700X
Medical Physician Assistant
55672
CA
Other
Enumeration date
09/30/2011
Last updated
01/11/2025
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