Individual
SUZANNE PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
325 LARCH STREET, POTLATCH, ID 83855
(208) 875-1551
Mailing address
3960 S HIGUERA ST, SPC 93, SAN LUIS OBISPO, CA 93401-1457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G072991
CA
Other
Enumeration date
08/31/2016
Last updated
08/17/2022
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