Individual
EDUARDO M SUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 PENNSYLVANIA AVE, SUITE 103, CHARLESTON, WV 25302
(304) 347-1296
(304) 293-6963
Mailing address
3110 MACCORKLE AVE SE, CHARLESTON, WV 25304-1210
(304) 347-1300
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10971
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0127803000
—
WV
Enumeration date
04/18/2007
Last updated
10/08/2013
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