Willie C Suhr, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A21044 Issued in CA

Practice address

800 Moorside Dr
Glendale, CA 91207-1136

Phone

(818) 507-7882

Fax

(818) 246-7387

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871501361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9060",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912260060",
            "telephone_number": "818-507-7882",
            "fax_number": "818-246-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MOORSIDE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912071136",
            "telephone_number": "818-507-7882",
            "fax_number": "818-246-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUHR",
        "first_name": "WILLIE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A21044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A210440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.