Individual
DR. SUSAN M PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1240 COLLEGE VIEW DR, RIVERTON, WY 82501-2288
(307) 856-1206
(307) 856-6056
Mailing address
1240 COLLEGE VIEW DR, RIVERTON, WY 82501-2288
(307) 856-1206
(307) 856-6056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4685A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117956000
—
WY
01
—
311702
BLUE CROSS BLUE SHIELD
WY
Enumeration date
05/06/2006
Last updated
08/05/2021
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