Redwine, Susan T

Redwine, Susan T is an individual health care provider with primary practice located at 200 N Bryant Ave , Edmond OK 73034-6273. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Redwine, Susan T can be contacted via phone (405) 330-7000.

Contact Information

Primary practice address
200 N Bryant Ave Edmond OK 73034-6273
Phone: (405) 330-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 22619 Oklahoma

Profile Details

NPI number 1144295775
LBN Legal business name Redwine, Susan T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Aug 4th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144295775 NPPES
Oklahoma MEDICAID 200066430A
Oklahoma Other 22619
Oklahoma Other 30634

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