Individual
DR. SUSAN BARBARA PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2535 MAPLECREST RD, SUITE 20, BETTENDORF, IA 52722-7709
(563) 332-1500
(563) 332-1005
Mailing address
2535 MAPLECREST RD, SUITE 20, BETTENDORF, IA 52722-7709
(563) 332-1500
(563) 332-1005
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24610
IA
207N00000X
Dermatology Physician
4301044740
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0222331
—
IA
01
—
22233
WELLMARK BCBS
IA
Enumeration date
07/14/2005
Last updated
07/08/2007
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