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Individual
SUSAN E MOONEY
Active
Individual
SUSAN E MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
10165
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00049403
BC BS VT
VT
05
—
0RE4679
—
VT
01
—
15P200
MVP
NH
05
—
30011083
—
NH
Enumeration date
09/26/2005
Last updated
05/08/2017
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