# SUSAN PAYNE ETHERIDGE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952480527
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | G195183 | CA | Yes |
| 2080P0202X | Pediatric Cardiology Physician | G195183 | CA | — |

## Other

- **Enumeration date:** 11/03/2006
- **Last updated:** 04/29/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1018632 | — | AK |