Individual
DR. DAN SUSKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 MEDICAL CENTER BLVD, GWINNETT WOMENS PAVILION, LAWRENCEVILLE, GA 30046-7693
(770) 921-4492
(770) 696-3358
Mailing address
PO BOX 2606, LILBURN, GA 30048-2606
(770) 921-4492
(770) 696-3358
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036883
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000700983B
—
GA
05
—
000700983D
—
GA
05
—
000700983F
—
GA
05
—
10052477
—
GA
05
—
117057
—
GA
05
—
322063
—
GA
01
—
52412187
BLUE CROSS
GA
Enumeration date
12/04/2006
Last updated
08/08/2011
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