Individual
SUSAN J CARSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 N NINE MOUNDS ROAD, VERONA, WI 53593
(908) 845-9531
Mailing address
8007 EXCELSIOR DRIVE, MADISON, WI 53717
(608) 829-5247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28496
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31510100
—
WI
Enumeration date
03/23/2006
Last updated
07/08/2007
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