Individual
SUSAN M MCMASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D O
Contact information
Practice address
1705 ARBOR WAY, COLORADO SPRINGS, CO 80905-2128
(719) 471-6512
(719) 572-9033
Mailing address
PO BOX 490, CASCADE, CO 80809-0490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
05-23055
KS
207Q00000X
Family Medicine Physician
Primary
29909
CO
207Q00000X
Family Medicine Physician
632
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01299098
—
CO
Enumeration date
08/09/2005
Last updated
08/17/2009
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