Etheridge, Susan P.
Etheridge, Susan P. is an individual health care provider with primary practice located at 305 E Jefferson St , Boise ID 83712-6231. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is her primary health care specialty. Etheridge, Susan P. can be contacted via phone (208) 381-7370.Contact Information
Primary practice address
305 E Jefferson St
Boise ID 83712-6231
Phone: (208) 381-7370
Fax: (208) 381-7387
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | M-17302 | Idaho |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 8186 | Alaska |
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | 273593-1205 | Utah |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 273593-1205 | Utah |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 8186 | Alaska |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 273593-1205 | Utah |
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | 8389 | Alaska |
Profile Details
| NPI number | 1952480527 |
|---|---|
| LBN Legal business name | Etheridge, Susan P. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2006 |
| Last updated | Jan 18th, 2024 - about 10 months 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 | 1952480527 | NPPES |
| Alaska | MEDICAID | 1018632 |
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