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Individual
DR. SUSAN M FERGUSON
Active
Individual
DR. SUSAN M FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4175
AL
207RX0202X
Medical Oncology Physician
4175
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009940155
—
AL
01
—
051519329
BCBS PROVIDER ID
AL
05
—
108623
—
AL
01
—
26-4105002
TAX ID
—
01
—
510-48638
BLUE CROSS BLUE SHIELD
AL
01
—
752974799
TAX ID
—
01
—
P00120269
RAILROAD MEDICARE/PGBA
AL
Enumeration date
01/03/2007
Last updated
06/02/2009
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