Doctor Name: | DR. SUSAN JENNIFER CARBOGNIN |
NPI Number: | 1407956956 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | AFE111304 |
Business Practice Address: | 1050 W Perimeter Rd Andrews Afb, MD - 207626601 |
Business Phone Number: | 2408572085 |
Business Fax Number: | |
Mailing Address: | 1050 W Perimeter Rd, ANDREWS AFB |
State: | MD |
Postal Code: | 207626601 |
Phone Number: | 2408572085 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2006 |
NPI Last Update Date: | 08/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | AFE111304 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |