Basic Information
Provider Information
NPI: 1275764888
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHATTERJEE
FirstName: SUMAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 50095
Address2:  
City: SEATTLE
State: WA
PostalCode: 981455095
CountryCode: US
TelephoneNumber: 2065436420
FaxNumber:  
Practice Location
Address1: 1959 NE PACIFIC ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981950001
CountryCode: US
TelephoneNumber: 2065984294
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/30/2009
LastUpdateDate: 07/30/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000XMD60054434WAY Allopathic & Osteopathic PhysiciansUrology 

No ID Information.


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