Provider Demographics
NPI:1528295862
Name:SUYDAM, FIONA GEORGIANA (MD)
Entity type:Individual
Prefix:
First Name:FIONA
Middle Name:GEORGIANA
Last Name:SUYDAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FIONA
Other - Middle Name:GEORGIANA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:720 BLACKBURN RD
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1459
Mailing Address - Country:US
Mailing Address - Phone:412-749-7850
Mailing Address - Fax:412-749-7784
Practice Address - Street 1:720 BLACKBURN RD
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1459
Practice Address - Country:US
Practice Address - Phone:412-749-7850
Practice Address - Fax:412-749-7784
Is Sole Proprietor?:No
Enumeration Date:2009-06-13
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD452113207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine