Shirley, Susan Elena
Shirley, Susan Elena is an sole proprietor health care provider with primary practice located at 311 W 8Th St Ne , Rome GA 30165-2723. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Shirley, Susan Elena can be contacted via phone (706) 291-8702.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 052830 | Georgia |
Profile Details
| NPI number | 1427107036 |
|---|---|
| LBN Legal business name | Shirley, Susan Elena |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 10th, 2007 |
| Last updated | Feb 5th, 2010 - about 14 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 | 1427107036 | NPPES |
| Georgia | MEDICAID | 598765966A | |
| Georgia | MEDICAID | 009942541 |
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