Individual
SUSAN LEAH GARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
916 W MAIN ST, BRIDGEPORT, WV 26330-1651
(304) 842-1034
(304) 842-1037
Mailing address
527 MEDICAL PARK DR STE 402, BRIDGEPORT, WV 26330-9010
(304) 842-1034
(304) 842-1037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20198
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005391
—
WV
01
—
WV3793A
MEDICARE PTAN
WV
Enumeration date
07/08/2006
Last updated
04/06/2022
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