Individual
DR. SUSAN KAYE BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1846 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30044-8801
(770) 696-9862
(770) 710-0243
Mailing address
1846 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30044-8801
(770) 696-9862
(770) 710-0243
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
033782
GA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
033782
GA
Other
Enumeration date
06/14/2006
Last updated
09/10/2012
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