Provider Demographics
NPI:1417571761
Name:SUHAIL, SAM K (MD, EDD, MPH, MBA)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:K
Last Name:SUHAIL
Suffix:
Gender:M
Credentials:MD, EDD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7170
Mailing Address - Country:US
Mailing Address - Phone:928-344-2000
Mailing Address - Fax:
Practice Address - Street 1:7201 E 31ST PL
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-8394
Practice Address - Country:US
Practice Address - Phone:928-336-5660
Practice Address - Fax:928-336-5672
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ738022084P0800X
IL0361687212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry