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Individual

DR. SUZANNE MARIE MICHALAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
Mailing address
PO BOX 810, HANOVER, NH 03755-0810
(603) 308-1472

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
272677
MA
207W00000X
Ophthalmology Physician
Primary
24467
NH
207W00000X
Ophthalmology Physician
A173232
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
272677
MASSACHUSETTS LICENSE NUMBER
MA
Enumeration date
06/15/2017
Last updated
01/04/2024
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