Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Khetisuda Suvarnasuddhi, MD

Individual provider Nephrology Physician · NPI 1083059455

Khetisuda Suvarnasuddhi, MD is a Nephrology in Hagerstown, Maryland. Qualified in 2012, 14 years ago. Practices with Otto Roza MD PA, a 10-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland and Rhode Island.

Years since qualifying
14
Licensed in
MD, RI
In the registry since
2013
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12931 Oak Hill Ave
Hagerstown, MD 21742
Phone: (301) 797-9600
Fax: (301) 797-3854
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence D0085666 (MD)
Nephrology Physician Taxonomy 207RN0300X · Licence LP03684 (RI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1083059455
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 30, 2013
Last updated in NPPESAugust 10, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Otto Roza Md Pa — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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