Davis, Susan
Davis, Susan is an individual health care provider with primary practice located at 111 Founders Plz Ste 400 , East Hartford CT 06108-3240. She recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Davis, Susan can be contacted via phone (860) 289-3375.Contact Information
Primary practice address
111 Founders Plz Ste 400
East Hartford CT 06108-3240
Phone: (860) 289-3375
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 59103 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 59103 | Massachusetts |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 59103 | Massachusetts |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 59103 | Massachusetts |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 59103 | Massachusetts |
| Other Service Providers / Specialist | 174400000X | 59103 | Massachusetts |
Profile Details
| NPI number | 1043206568 |
|---|---|
| LBN Legal business name | Davis, Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Apr 17th, 2020 - about 4 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 | 1043206568 | NPPES |
| Massachusetts | MEDICAID | 3040780 |
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