Susser, Shawn A
Susser, Shawn A is an individual health care provider with primary practice located at 10240 Park Meadows Dr , Lone Tree CO 80124-5425. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Susser, Shawn A can be contacted via phone (303) 338-4545.Contact Information
Primary practice address
10240 Park Meadows Dr
Lone Tree CO 80124-5425
Phone: (303) 338-4545
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 993 | Colorado |
Profile Details
| NPI number | 1164559142 |
|---|---|
| LBN Legal business name | Susser, Shawn A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Apr 28th, 2021 - about 3 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 | 1164559142 | NPPES |
| Other | 010396 | KAISER-COMMERCIAL NUMBER | |
| MEDICAID | 79107010 | KAISER-COMMERCIAL NUMBER |
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