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Individual
DR. DANIEL SUSANTO
Active
Individual
DR. DANIEL SUSANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
MD60083485
WA
2085R0202X
Diagnostic Radiology Physician
17687
MN
2085R0202X
Diagnostic Radiology Physician
M-12378
ID
2085R0202X
Diagnostic Radiology Physician
MD60083485
WA
2085R0202X
Diagnostic Radiology Physician
S-7900
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144364605
—
ID
05
—
1584895
—
AK
05
—
2007663
—
WA
01
—
263299
LNI
WA
01
—
263302
LNI
WA
01
—
263305
LNI
WA
Enumeration date
02/17/2007
Last updated
02/11/2026
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