Provider Demographics
NPI:1215944129
Name:SUDING, PAUL WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:WILLIAM
Last Name:SUDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 EXEMPLA CIR
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3397
Mailing Address - Country:US
Mailing Address - Phone:303-689-6560
Mailing Address - Fax:303-689-6550
Practice Address - Street 1:300 EXEMPLA CIR
Practice Address - Street 2:SUITE 360
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3397
Practice Address - Country:US
Practice Address - Phone:303-689-6560
Practice Address - Fax:303-689-6550
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND17101208600000X
CAA90424208600000X
WAMD61055807208600000X
CODR.0052704208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05909872Medicaid