Individual
SUSAN HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-2818
(774) 442-7799
Mailing address
PO BOX 415348, BOSTON, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
268582
MA
Other
Enumeration date
06/06/2013
Last updated
11/08/2020
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