Individual
KENNETH SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 741-0150
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22447
MN
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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