Provider Demographics
NPI:1902957400
Name:SUER, ROBERT P (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:SUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 W WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-4264
Mailing Address - Country:US
Mailing Address - Phone:765-289-5006
Mailing Address - Fax:765-213-4951
Practice Address - Street 1:4000 W WOODWAY DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-4264
Practice Address - Country:US
Practice Address - Phone:765-289-5006
Practice Address - Fax:765-213-4951
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027878A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000880436OtherANTHEM BCBS
IN100344600AMedicaid
ININ1953001OtherMEDICARE
IN100344600AMedicaid