Individual
DR. SUSAN MARIE DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27018
SC
207R00000X
Internal Medicine Physician
LL27018
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270183
—
SC
01
—
P00924682
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
10/27/2006
Last updated
05/07/2025
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