Individual
SUETTA TENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
GENESIS HEALTH CARE WINWARD GARDENS NURSING CENTER, 105 MECHANIC STREET, CAMDEN, ME 04843
(207) 236-4197
(207) 230-0563
Mailing address
PO BOX 42738, TOWSON, MD 21284-2738
(410) 494-7607
(610) 925-7387
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71345
MA
207R00000X
Internal Medicine Physician
Primary
MD22576
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701800
BC BS ANTHEM
—
01
—
110229385
RAILROAD MEDICARE
—
05
—
3002764
—
MA
01
—
4978
FALLON
—
01
—
69626
HARVARD PILGRAM
—
01
—
712914
TUETS HEALTH PLAN
—
01
—
71345
MASS LICENSE #
—
Enumeration date
11/28/2006
Last updated
03/07/2023
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