Mahle, Susan K.
Mahle, Susan K. is an individual health care provider with primary practice located at 12720 Bass Lake Rd , Maple Grove MN 55369-6307. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mahle, Susan K. can be contacted via phone (763) 559-2861.Contact Information
Primary practice address
12720 Bass Lake Rd
Maple Grove MN 55369-6307
Phone: (763) 559-2861
Fax: (763) 559-1338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 23762 | Minnesota |
Profile Details
| NPI number | 1033186622 |
|---|---|
| LBN Legal business name | Mahle, Susan K. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Sep 22nd, 2011 - about 13 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 | 1033186622 | NPPES |
| Minnesota | MEDICAID | 920795300 |
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