Doctor Name: | SUSIE A JOHN |
NPI Number: | 1194714956 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD MPH |
License Number: | 85216 |
Business Practice Address: | Us Hwy 491 North Shiprock, NM - 87420 |
Business Phone Number: | 5053686401 |
Business Fax Number: | 5053686431 |
Mailing Address: | Po Box 160, SHIPROCK |
State: | NM |
Postal Code: | 874200160 |
Phone Number: | 5053686401 |
Fax Number: | 5053686431 |
NPI Enumeration Date: | 10/14/2005 |
NPI Last Update Date: | 12/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080A0000X |
License Number: | 85216 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |