Individual
DR. JESSE G SUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 OLD BALLAS RD STE 100, SAINT LOUIS, MO 63141-7083
(314) 733-9009
Mailing address
675 OLD BALLAS RD STE 100, SAINT LOUIS, MO 63141-7083
(314) 733-9009
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R7B02
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0900102
UNITED HEALTHCARE
MO
01
—
1092007002
CIGNA
MO
01
—
171747
HEALTHLINK
MO
01
—
200042300
RAILROAD MEDICARE
MO
05
—
203085907
—
MO
01
—
22344
BLUE CROSS BLUE SHIELD
MO
01
—
4420147
AETNA
MO
01
—
83374V3223
GROUP HEALTH PLAN
MO
Enumeration date
06/23/2006
Last updated
11/01/2021
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