Doctor Name: | DR. SUSAN ELIZABETH ERREDGE |
NPI Number: | 1174597397 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.P.M. |
License Number: | 1431 |
Business Practice Address: | Route 301 North 21 B Ave Zuni, NM - 873270467 |
Business Phone Number: | 5057824431 |
Business Fax Number: | |
Mailing Address: | Po Box 467, Route 301 North 21 B Ave ZUNI |
State: | NM |
Postal Code: | 873270467 |
Phone Number: | 5057824431 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2006 |
NPI Last Update Date: | 02/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 1431 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |