# SUSQUEHANNA OB-GYN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215740154
- **Authorized official:** VICTORIA DODSON (CREDENTIALING MANAGER)
- **Authorized official phone:** (443) 398-0189

## Contact information

- **Practice address:** 308 N UNION AVE, HAVRE DE GRACE, MD 21078-2825
- **Practice address phone:** (410) 939-3121
- **Practice address fax:** (443) 643-4303
- **Mailing address:** 520 UPPER CHESAPEAKE DR STE 301, BEL AIR, MD 21014-4375
- **Mailing address phone:** (410) 939-3121
- **Mailing address fax:** (443) 643-4303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/27/2025
- **Last updated:** 01/27/2025