Individual
MARK R SUSSKIND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(707) 426-3911
(707) 434-2043
Mailing address
10470 OLD PLACERVILLE RD, #100, SACRAMENTO, CA 95827-2539
(866) 681-0736
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G63205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G632050
—
CA
Enumeration date
10/16/2006
Last updated
05/26/2015
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