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Individual
SUSAN J FANBURG
Active
Individual
SUSAN J FANBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13665
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10385619
CAQH
—
Enumeration date
10/26/2006
Last updated
08/14/2015
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