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Individual
SUSAN MABROUK
Active
Individual
SUSAN MABROUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0116019438
VA
208000000X
Pediatrics Physician
Primary
D70788
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035464300
—
MD
Enumeration date
04/30/2008
Last updated
10/28/2013
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