Provider Demographics
NPI:1992759880
Name:SUHER, BERNARD (DPM)
Entity type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:
Last Name:SUHER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 653
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-794-4550
Mailing Address - Fax:804-794-7648
Practice Address - Street 1:13510 MIDLOTHIAN TURNPIKE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113
Practice Address - Country:US
Practice Address - Phone:804-794-4550
Practice Address - Fax:804-794-7648
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010300190213ES0103X
VA0103000190213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA93-0019-8Medicaid
VA009300198Medicare ID - Type Unspecified
VA93-0019-8Medicaid
VAU24010Medicare UPIN