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Individual

DR. SUSAN SUTPHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6760 JIMMY CARTER BLVD, SUITE 150, NORCROSS, GA 30071-1278
(678) 892-2000
Mailing address
791 OAK ST, HAPEVILLE, GA 30354-1748
(404) 601-2000
(404) 559-0257

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
037396
GEOGIA MEDICAL LICENSE
GA
Enumeration date
11/05/2008
Last updated
11/05/2008
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