Tate, Susan J

Tate, Susan J is an individual health care provider with primary practice located at 4076 Neely Road , Fort Wainwright AK 99703. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as her primary health care specialty. Tate, Susan J can be contacted via phone (907) 361-5479.

Contact Information

Primary practice address
4076 Neely Road Fort Wainwright AK 99703
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4295 Alaska

Profile Details

NPI number 1184611519
LBN Legal business name Tate, Susan J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated May 1st, 2018 - about 6 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 1184611519 NPPES
Alaska MEDICAID MD0991

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