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Individual

SUSAN J FANBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
696 DANIEL WEBSTER HWY, MERRIMACK, NH 03054-2748
(603) 424-3155
(603) 424-8693
Mailing address
696 DANIEL WEBSTER HWY, MERRIMACK, NH 03054-2748
(603) 424-3155
(603) 424-8693

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13665
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10385619
CAQH
Enumeration date
10/26/2006
Last updated
08/14/2015
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