| Doctor Name: | SUSAN CLARKSON MCGINNIS |
| NPI Number: | 1033227186 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN BC |
| License Number: | 205358 |
| Business Practice Address: | 1400 Vfw Pkwy West Roxbury, MA - 021324927 |
| Business Phone Number: | 8572036200 |
| Business Fax Number: | 8572035567 |
| Mailing Address: | 411 Bunker Hill St, CHARLESTOWN |
| State: | MA |
| Postal Code: | 021291719 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/28/2006 |
| NPI Last Update Date: | 08/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 205358 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |