Individual
DR. SUSAN J. ROE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1175 NININGER RD, HASTINGS, MN 55033-1056
(651) 480-4100
(651) 480-6801
Mailing address
1175 NININGER RD, HASTINGS, MN 55033-1056
(651) 480-4100
(651) 480-6801
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
30221
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-00304
MEDICA
MN
01
—
138T5RO
BLUE CROSS
MN
01
—
984811034012
PREFERRED ONE
MN
01
—
HP42296
HEALTHPARTNERS
MN
Enumeration date
03/17/2006
Last updated
07/08/2007
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