Doctor Name: | DR. MEHGAN M SUSEK |
NPI Number: | 1013271873 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.P.M. |
License Number: | SC006388 |
Business Practice Address: | 1800 Mulberry St Scranton, PA - 185102369 |
Business Phone Number: | 5709698000 |
Business Fax Number: | |
Mailing Address: | 436 Colfax Ave, SCRANTON |
State: | PA |
Postal Code: | 185102363 |
Phone Number: | 5702620180 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2012 |
NPI Last Update Date: | 06/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | SC006388 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |