Smith, Susan M

Smith, Susan M is an individual health care provider with primary practice located at 36500 Aurora Dr , Summit WI 53066-4899. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Smith, Susan M can be contacted via phone (262) 434-1000.

Contact Information

Primary practice address
36500 Aurora Dr Summit WI 53066-4899
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 53408 Arizona
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 66740 Wisconsin

Profile Details

NPI number 1740444850
LBN Legal business name Smith, Susan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2008
Last updated Jun 1st, 2022 - about 2 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 1740444850 NPPES
Wisconsin MEDICAID 100065488

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