Roach, Susan I
Roach, Susan I is an individual health care provider with primary practice located at 1309 Sunset St , Longmont CO 80501-3215. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Roach, Susan I can be contacted via phone (303) 772-5578.Contact Information
Primary practice address
1309 Sunset St
Longmont CO 80501-3215
Phone: (303) 772-5578
Fax: (303) 772-8207
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 24757 | Colorado |
Profile Details
| NPI number | 1467454694 |
|---|---|
| LBN Legal business name | Roach, Susan I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Apr 25th, 2008 - about 17 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 | 1467454694 | NPPES |
| Colorado | MEDICAID | 01247576 |
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