Individual
DR. SUSAN STANTON DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 EASTGATE AVE, MONESSEN, PA 15062-1393
(724) 684-6489
(724) 684-7116
Mailing address
2 EASTGATE AVE, MONESSEN, PA 15062-1393
(724) 684-6489
(724) 684-7116
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD429498
PA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD429498
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023068350001
—
PA
Enumeration date
05/31/2007
Last updated
03/18/2016
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