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Individual
SUSAN G ROUX
Active
Individual
SUSAN G ROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G60193
CA
2085N0700X
Neuroradiology Physician
G60193
CA
2085N0904X
Nuclear Radiology Physician
G60193
CA
2085P0229X
Pediatric Radiology Physician
G60193
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G60193
CA
2085R0204X
Vascular & Interventional Radiology Physician
G60193
CA
2085U0001X
Diagnostic Ultrasound Physician
G60193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G601930
BLUE SHIELD
CA
Enumeration date
08/05/2006
Last updated
12/12/2007
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