Datta, Susan Marie
Datta, Susan Marie is an individual health care provider with primary practice located at 180 Wingo Way Suite 306, Mt Pleasant SC 29464-1810. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Datta, Susan Marie can be contacted via phone (843) 884-1777.Contact Information
Primary practice address
180 Wingo Way Suite 306
Mt Pleasant SC 29464-1810
Phone: (843) 884-1777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | LL27018 | South Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 27018 | South Carolina |
Profile Details
| NPI number | 1528144151 |
|---|---|
| LBN Legal business name | Datta, Susan Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2006 |
| Last updated | Nov 20th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528144151 | NPPES |
| South Carolina | Other | P00924682 | RAILROAD MEDICARE ID-RSFPN |
| South Carolina | MEDICAID | 270183 | RAILROAD MEDICARE ID-RSFPN |
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